Tiblad Eleonor, Ek Sverker, Kublickas Marius, Lindgren Peter
Center for Fetal Medicine, Karolinska University Hospital - Stockholm, Sweden - Center for Fetal Medicine Stockholm, Sweden.
Center for Fetal Medicine - Karolinska University Hospital Stockholm, Sweden Center for Fetal Medicine - Karolinska University Hospital Stockholm, Sweden.
Lakartidningen. 2017 Aug 29;114:ELXE.
Invasive fetal therapy Invasive fetal therapy in Sweden consists of fetoscopic interventions to treat twin-to-twin transfusion syndrome (TTS) or twin anemia polycytemia sequence (TAPS) in monochorionic twin or triplet pregnancies and for selective reduction in monochorionic twins complicated by discordant anomalies or severe growth retardation in one fetus. Alternative methods, such as intrafetal laser ablation and radio frequency ablation, are also used for selective reduction and rarely to treat fetal tumors. Ultrasound guided intrauterine blood transfusions to treat fetal anemia have been performed for a long time with excellent results. Placement of thoraco-amniotic shunts and vesico-amniotic shunts is indicated in a few cases per year in Sweden. Since these rare interventions were centralized to one national center in 2013, the outcome of the fetal interventions has improved consistently.
侵入性胎儿治疗 瑞典的侵入性胎儿治疗包括通过胎儿镜干预来治疗单绒毛膜双胎或三胎妊娠中的双胎输血综合征(TTS)或双胎贫血-红细胞增多序列征(TAPS),以及对合并不一致性畸形或一胎严重生长受限的单绒毛膜双胎进行选择性减胎。诸如胎儿体内激光消融和射频消融等替代方法也用于选择性减胎,很少用于治疗胎儿肿瘤。超声引导下的宫内输血治疗胎儿贫血已开展很长时间,效果良好。瑞典每年有少数病例需要放置胸-羊膜分流管和膀胱-羊膜分流管。自2013年这些罕见干预措施集中到一个国家中心进行后,胎儿干预的结果持续改善。