Fetoscopy in the practice of perinatology and obstetrics.

The clinical indications for fetoscopy in perinatal medicine are encompassing an ever widening circle of inherited diseases and teratologically induced disorders that can now or potentially be diagnosed in utero. Fetoscopy, which has evolved over the past 20 years into a clinically accepted procedure, is not without risk to the pregnant mother and the fetus. When the decision is made to perform the procedure, its merits should outweigh its inherent risks and it should be performed by a perinatologist experienced in the technique. Fetoscopy is appropriate when the fetus is at risk for teratologically induced malformation, inherited blood dyscrasias, sex-linked or autosomal abnormalities with gross malformations, or neural tube disorders that cannot be diagnosed by amniocentesis. Technical improvements should result in increased refinement and wider applicability of the technique in the future.