When you are pregnant, your biggest hope is to give birth to a healthy baby. But sometimes, after the scan, the doctor tells you that there is a problem with the baby in your womb. The fear and anxiety you feel at such a time cannot be expressed in words. But did you know that today's medical science is so advanced that some medical conditions can be treated even before the baby is born, that is, while it is still in the womb. That is what we are going to talk about today.
Simply put, what is Fetoscopy?
Fetoscopy is a type of endoscopy that is used to look at the baby in your womb. Imagine that a very thin, fiber-like tube (called a fetoscope) is inserted through a small incision in your belly and into your uterus. There is a small camera at the end of this tube. The images from the camera can be viewed by the doctor on a large screen. The baby, placenta, and amniotic sac inside the uterus can then be clearly seen.
The specialty of this is that, since this tube is hollow inside, it is possible to pass very delicate surgical instruments through it to treat some of the baby's medical conditions and, if necessary, take a piece of tissue for examination (a `biopsy`). In some cases, this tube is also inserted through the vagina and into the cervix.
When is a fetoscopy necessary?
This is not something that is done for everyone. It is mainly used during the second or third trimester of pregnancy to treat congenital (born-in) conditions in the baby. Some of these conditions, if left untreated, can be life-threatening to the pregnancy or the baby.
Let's look at the table below to see when this method is most commonly used.
| Medical condition | Simple explanation and treatment |
|---|---|
| Twin-to-twin transfusion syndrome | This is a rare but dangerous condition that occurs in unborn twins who share the same placenta. This is where blood flow from one baby to the other is uneven. Fetoscopy finds these abnormal blood vessels in the placenta and uses a laser to seal them off. This is called fetoscopic laser photocoagulation . |
| Amniotic band syndrome | This is when the amniotic sac, which is the bag of water that surrounds the baby, becomes entangled in the baby's body, like a band of tissue. This can cut off blood flow to the baby's limbs, or even cause them to become severed. Fetoscopy uses a laser beam to cut the entangled bands and free the baby. |
| Congenital diaphragmatic hernia (CDH) | This occurs when a hole forms in the baby's diaphragm (the muscle that separates the chest and abdomen). This allows the organs in the abdomen to move into the chest and press on the lungs. This prevents the lungs from developing properly. Fetoscopy involves inserting a small tube into the baby's trachea to stimulate lung development. The tube is removed after a few weeks. This procedure is called fetoscopic endoluminal tracheal occlusion (FETO) . |
In addition, this method is also used to treat other congenital conditions such as placental tumors and spina bifida.
How do you prepare for this surgery?
If your doctor decides that you need this surgery, he or she will explain to you in detail how to prepare for it. This may vary from person to person.
- It depends on whether the surgery is done through the abdomen or vagina.
- It depends on whether you will be given local anesthesia or general anesthesia .
- It depends on whether or not you give other medications to reduce the baby's movements during the surgery.
Talk to your doctor about all your questions and fears. They will explain everything to you and take good care of you.
How Fetoscopy is performed
This surgery is usually done in an operating room. You will be given anesthesia and medication to keep you and your baby still during the procedure.
What happens next, in simple terms, is this:
1. A small incision: The doctor will make a very small incision in the skin of your abdomen.
2. Insertion of the fetoscope: Through the incision, the fetoscope tube is carefully passed into the uterus and the amniotic sac where the baby is.
3. Viewing on a screen: Since the images from the camera on the tube are displayed on a large screen, the doctor can take a good look at both the baby and the placenta.
4. Treatment: Next, depending on the treatment required, delicate surgical instruments are inserted through the same tube and the necessary procedure is performed. This could mean performing a laser treatment or taking a tissue sample.
Is this a major surgery? What are the risks?
Fetoscopy is a minimally invasive procedure. This means that it is performed through a small incision, without any large incisions, so there is very little damage to the body. Other alternative methods require a larger incision in the abdomen, and their risks are much higher.
However, like any surgery, this one is not without its risks. But remember, doctors only decide to perform this surgery when the benefits to the baby and mother are much greater than not having the surgery.
| Possible risks of fetoscopy | |
|---|---|
| Preterm birth | The birth of a child before the due date. |
| Premature labor | Premature ejaculation. |
| Early rupture of the water bag | Preterm premature rupture of membranes (PPROM). |
| Pregnancy loss | Miscarriage as a complication of surgery. |
| Infection | Infection of the uterus or mother. |
| Bleeding | Excessive bleeding. |
What happens after the surgery?
After the fetoscopy, the doctor receives very important information about the baby's condition. Accordingly, the next steps are decided.
- How the baby is delivered: Depending on the baby's condition, it is decided whether a vaginal delivery or a cesarean section (C-section) is safest.
- Where the baby will be delivered: If the baby requires specialized medical facilities after birth, the delivery will be planned at a hospital that has those facilities.
- When the baby is due: Sometimes it may be necessary to deliver the baby early, rather than waiting until the pregnancy is complete.
The time it takes to get the results depends on the reason for the surgery. For example, if you had laser treatment, you can know if it was successful right after the surgery. However, if you had a biopsy, it will take a few days for the results to come back.
How long does it take to heal?
Since this is a minimally invasive procedure, recovery time is short. Most people can return to normal activities the same day. However, you need to be very careful about the incision site. However, your doctor will give you specific instructions based on your specific condition.
Take-Home Message
- Fetoscopy is a specialized, advanced surgical procedure used to treat certain serious medical conditions in babies in the womb.
- This is only done in cases where there is a risk to the baby's life or the pregnancy, and if the benefit of treatment far outweighs the risk.
- Although it is a minimally invasive procedure, as with all surgeries, there are some risks.
- If you're going to have this kind of surgery, it's normal to feel nervous. Talk to your doctor about any concerns you may have and relax. They're committed to providing the best for you and your baby.
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