胎儿镜检查技术：迈向微创胎儿治疗的一步。
The art of fetoscopy: a step toward minimally invasive fetal therapy.
作者信息
Deka Dipika, Dadhwal Vatsla, Gajatheepan S B, Singh Aprajita, Sharma K Aparna, Malhotra Neena
机构信息
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029 India.
出版信息
J Obstet Gynaecol India. 2012 Dec;62(6):655-9. doi: 10.1007/s13224-012-0232-y. Epub 2012 Aug 17.
PURPOSE
To study the feasibility, learning curve, and safety of fetoscopy, so that fetal surgery can be confidently performed in ongoing pregnancies.
METHODS
Fetoscopy was performed at 12-20 weeks of gestation, in 12 women with fetal congenital malformations and/or for termination of pregnancy, under local anesthesia using fine fetoscopes ranging from 1 to 2-mm diameter. The fetal parts and placenta were examined for clarity of vision, identification, and anomalies.
RESULTS
Fetoscopy required great skill, patience, and extensive use of ultrasound for correct orientation. Visualization was better with endoscope of 2-mm diameter. Laser coagulation of placental vessels using diode laser system was possible in the last two cases. There were no major complications.
CONCLUSIONS
Fetal endoscopy is a feasible procedure, safe in experienced hands but has an appreciable learning curve.
目的
研究胎儿镜检查的可行性、学习曲线及安全性，以便能在正在进行的妊娠中自信地开展胎儿手术。
方法
在妊娠12至20周时，对12例患有胎儿先天性畸形和/或要求终止妊娠的孕妇，使用直径为1至2毫米的精细胎儿镜在局部麻醉下进行胎儿镜检查。检查胎儿部位和胎盘，以观察视野清晰度、进行识别及发现异常情况。
结果
胎儿镜检查需要高超的技巧、耐心，并大量使用超声以正确定位。直径2毫米的内窥镜视野更好。最后两例中使用二极管激光系统对胎盘血管进行激光凝固是可行的。未发生重大并发症。
结论
胎儿内窥镜检查是一种可行的操作，在经验丰富的医生手中是安全的，但有明显的学习曲线。
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