Title: Fetal surgery is a clinical reality
Authors: Deprest, Jan
Devlieger, Roland
Srisupundit, Kasemsri
Beck, Veronika
Sandaite, Inga
Rusconi, Silvia
Claus, Filip
Naulaers, Gunnar
Van De Velde, Marc
Brady, Paul
Devriendt, Koenraad
Vermeesch, Joris
Toelen, Jaan
Carlon, Marianne
Debyser, Zeger
De Catte, Luc
Lewi, Liesbeth # ×
Issue Date: Feb-2010
Publisher: Elsevier
Series Title: Seminars in Fetal and Neonatal Medicine vol:15 issue:1 pages:58-67
Abstract: An increasing number of fetal anomalies are being diagnosed prior to birth, some of them amenable to fetal surgical intervention. We discuss the current clinical status and recent advances in endoscopic and open surgical interventions. In Europe, fetoscopic interventions are widely embraced, whereas the uptake of open fetal surgery is much less. The indications for each access modality are different, hence they cannot substitute each other. Although the stage of technical experimentation is over, most interventions remain investigational. Today there is level I evidence that fetoscopic laser surgery for twin-to-twin transfusion syndrome is the preferred therapy, but this operation actually takes place on the placenta. In terms of surgery on the fetus, an increasingly frequent indication is severe congenital diaphragmatic hernia as well as myelomeningocele. Overall maternal safety is high, but rupture of the membranes and preterm delivery remain a problem. The increasing application of fetal surgery and its mediagenicity has triggered the interest to embark on fetal surgical therapy, although the complexity as well as the overall rare indications are a limitation to sufficient experience on an individual basis. We plead for increased exchange between high volume units and collaborative studies; there may also be a case for self-regulation. Inclusion of patients into trials whenever possible should be encouraged rather than building up casuistic experience.
ISSN: 1744-165X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Department of Human Genetics - miscellaneous
Basic Research in Gynaecology Section (-)
Pathophysiology of Pregnancy Section (-)
Section Woman - Miscellaneous (-)
Section Newborn (-)
Anesthesiology and Algology
Laboratory for Cytogenetics and Genome Research
Molecular Virology and Gene Therapy
Foetal Medicine Section (-)
× corresponding author
# (joint) last author

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