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Fetoscopy Role in Fetal Surgery and Fetal Medicine
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作者 Wael S. S. Elbanna Ibrahim A. Oun +3 位作者 Emad M. Abd Ellatif Wael R. Hablas Walid I. El Shaikh Yehia A. Wafa 《Open Journal of Obstetrics and Gynecology》 2019年第11期1477-1485,共9页
Aim: We attempted to illustrate our experience of fetoscopic therapy in a tertial institute, whereby to highlight the present Egyptian situation regarding this issue. We described fetoscopic therapy undergone at Al-Hu... Aim: We attempted to illustrate our experience of fetoscopic therapy in a tertial institute, whereby to highlight the present Egyptian situation regarding this issue. We described fetoscopic therapy undergone at Al-Hussein Hospital, Al-Azhar University, Cairo, Egypt, from Dec-2012 to Sep-2019. Presentation of cases: Sixteen women with 17 fetuses were included in the analysis of this study with a mean age of 25.31 ± 6.15 years;four with positive marriage to a near relevant, and eight were primigravida. The fetus of twelve women had lower urinary tract obstruction (LUTO), two fetal anemia, one hydrothorax, and one twin-to-twin transfusion syndrome (TTTS). The mean time for fetoscopy was gestational week 24.13 ± 3.77. We did therapeutic drainage to amniotic fluid in hydrothorax and LUTO, therapeutic septostomy to the TTTS case, and blood transfusion in cases of fetal anemia. During the operation, the procedure succeeded in 14 out of 16 women. Overall, nine of the 16 women experienced some complications;five with rupture of membranes, four with preterm labor, and three with intrauterine fetal death (IUFD). Conclusion: Fetoscopy can manage LUTO and well-selected cases of TTTS, hydrothorax, and fetal anemia. The procedure is promising. Fetoscopic therapy has just begun in Egypt, and this report may contribute to the future advance of fetoscopic therapy in Egypt. 展开更多
关键词 fetoscopy Lower URINARY TRACT OBSTRUCTION LUTO Twin-to-Twin TRANSFUSION Syndrome Fetal ANEMIA Complications Rate
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Evaluation of Fetoscopy Role in Fetal Surgery and Fetal Medicine
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作者 Wael S. S. Elbanna Ibrahim A. Oun +3 位作者 Emad M. Abd Ellatif Wael R. Hablas Walid I. El Shaikh Yehia A. Wafa 《Open Journal of Obstetrics and Gynecology》 2018年第11期946-957,共12页
Introduction: This study aimed to evaluate, discuss and illustrate the role of fetoscopy diagnostically and therapeutically. Material and Methods: This study was conducted in private center in under the supervision of... Introduction: This study aimed to evaluate, discuss and illustrate the role of fetoscopy diagnostically and therapeutically. Material and Methods: This study was conducted in private center in under the supervision of the professors of Azhar University, Egypt from Dec-2012 to Mar-2017. Women with confirmed fetal congenital malformations, and willing to do fetoscopy were recruited. Fetoscopy was attempted in all cases to treat the underlying fetal conditions. Follow up was made until delivery. Results: Twenty patients with 22 fetuses were included in this study with different congenital anomalies. Therapeutic drainage or coagulation was made in all cases. In cases of lower urinary tract obstruction, fetoscopy confirmed pre-suspected urethral atresia and changed the diagnosis from complete PUV to urethral atresia in some cases. The procedure succeeded in all cases. However, the on-going success rate was 17 (77.3%) of fetuses. The overall number of live birth was 11 fetuses (50%). Overall, 15 (75%) of the 20 patients experienced some complication withpreterm labor the most prevalent 15 (75%). Conclusion: Fetoscopy can diagnose and differentiate between posterior urethral valve (PUV) and atresia, and manage well-selected cases of twin to twin transfusion syndrome (TTTS), and have a reasonable survival rate in lower urinary tract obstruction (LUTO). 展开更多
关键词 fetoscopy Lower Urinary Tract Obstruction LUTO Twin-to-Twin TRANSFUSION Syndrome HYDROCEPHALUS HYDROTHORAX SACROCOCCYGEAL TERATOMA Complications Rate
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Application of fetoscopy in the management of monochorionic multiple pregnancies 被引量:4
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作者 ZHAO Yang-yu XIONG Guang-wu MA Cai-hong WEI Yuan WANG Li-na QIAO Jie 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第1期105-107,共3页
The complications of monochorionic (MC) multiple pregnancies include twin-reversed arterial perfusion(TRAP) and twin-to-twin transfusion syndrome (TTTS). Currently, the most effective treatment for stages Ⅱ,Ⅲ,... The complications of monochorionic (MC) multiple pregnancies include twin-reversed arterial perfusion(TRAP) and twin-to-twin transfusion syndrome (TTTS). Currently, the most effective treatment for stages Ⅱ,Ⅲ, and Ⅳ TTTS is generally considered to be fetoscopic laser occlusion of chorioangiopagous vessels (FLOC).3 MC twins who are severely discordant for growth or demonstrate anomalies may undergo selective reduction by means of a variety of different techniques.4 Radiofrequency ablation (RFA) of an acardiac twin has also proved to be an effective method of improving survival of the pump twin in the TRAP. Therefore, care for these complex pregnancies is ideally a coordinated multidisciplinary effort between perinatology, pediatric/fetal surgery, pediatric neurology, radiology/ ultrasound, genetics, social services, neonatology, and labor and delivery. 展开更多
关键词 pregnancy reduction multifetal fetoscopy twin-to-twin transfusion syndrome twins mono^gotic
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Real-time computerized video enhancement for minimally invasive fetoscopic surgery 被引量:1
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作者 Praneeth Sadda John Onofrey +3 位作者 Metehan Imamoglu Xenophon Papademetris Bilal Qarni Mert Ozan Bahtiyar 《Laparoscopic, Endoscopic and Robotic Surgery》 2018年第2期27-32,共6页
Background:The only definitive treatment for twin-to-twin transfusion syndrome is minimally invasive fetoscopic surgery for the selective coagulation of placental blood vessels.Fetoscopic surgery is a technically chal... Background:The only definitive treatment for twin-to-twin transfusion syndrome is minimally invasive fetoscopic surgery for the selective coagulation of placental blood vessels.Fetoscopic surgery is a technically challenging operation,mainly due to the poor visibility conditions in the uterine environment.We present the design of an algorithm for the computerized enhancement of fetoscopic video and show that the enhanced video increases the ability of human users to identify blood vessels within fetoscopic video rapidly and accurately.Methods:A computer algorithm for the enhancement of fetoscopic video frames was created.First,optical fiber artifacts were removed via a modification of unsharp masking.Second,image contrast was increased via Contrast Limited Adaptive Histogram Equalization(CLAHE).Third,the effect of contrast enhancements on stationary features was removed by normalizing to a windowed mean of the video frames.Fourth,color information was reincorporated by combining the mean-normalized result with the unnormalized contrast enhanced image using the soft light blending algorithm.Medical trainees(n?16)were recruited into a study to validate the algorithm.Subjects were shown enhanced or unenhanced fetoscopic video frames on a screen and were asked to identify whether a randomly placed marker fell on a blood vessel or on background.The accuracy of their responses was recorded.Results:On the subset of images where subjects had the lowest mean accuracy in identifying the placement of the marker,subjects performed better when viewing video frames enhanced by the computer(accuracy 74.27%;SE 0.97)than when viewing unenhanced video frames(accuracy 63.78%;SE 2.79).This result was statistically significant(p<0.01).Conclusion:Real-time computerized enhancement of fetoscopic video has the potential to ease the readability of video in poor lighting conditions,thus providing a benefit to the surgeon intraoperatively. 展开更多
关键词 Computer enhancement Fetoscopic surgery fetoscopy Twin-to-twin transfusion syndrome Placental vasculature
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A collagen plug with shape memory to seal iatrogenic fetal membrane defects after fetoscopic surgery
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作者 Rob T.C.Meuwese Elly M.M.Versteeg +5 位作者 Joris van Drongelen Daniëlle de Hoog Debora Bouwhuis Frank P.H.A.Vandenbussche Toin H.van Kuppevelt Willeke F.Daamen 《Bioactive Materials》 SCIE CSCD 2023年第2期463-471,共9页
Iatrogenic preterm premature rupture of fetal membranes(iPPROM)after fetal surgery remains a strong trigger for premature birth.As fetal membrane defects do not heal spontaneously and amniotic fluid leakage and chorio... Iatrogenic preterm premature rupture of fetal membranes(iPPROM)after fetal surgery remains a strong trigger for premature birth.As fetal membrane defects do not heal spontaneously and amniotic fluid leakage and chorioamniotic membrane separation may occur,we developed a biocompatible,fetoscopically-applicable collagen plug with shape memory to prevent leakage.This plug expands directly upon employment and seals fetal membranes,hence preventing amniotic fluid leakage and potentially iPPROM.Lyophilized typeⅠcollagen plugs were given shape memory and crimped to fit through a fetoscopic cannula(Ø3 mm).Expansion of the plug was examined in phosphate buffered saline(PBS).Its sealing capacity was studied ex vivo using human fetal membranes,and in situ in a porcine bladder model.The crimped plug with shape memory expanded and tripled in diameter within 1 min when placed into PBS,whereas a crimped plug without shape memory did not.In both human fetal membranes and porcine bladder,the plug expanded in the defect,secured itself and sealed the defect without membrane rupture.In conclusion,collagen plugs with shape memory are promising as medical device for rapid sealing of fetoscopic defects in fetal membranes at the endoscopic entry point. 展开更多
关键词 Biomaterial CROSSLINKING fetoscopy Fetal therapy Medical device Regenerative medicine
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Prenatal diagnosis of anhidrotic ectodermal dysplasia with unconventional loci abnormalities: a case report
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作者 CHEN Lian ZHAO Yang-yu +6 位作者 WEI Yuan WANG Yan ZHANG Yan WANG Yong-qing LIU Jian-ying YANG Yong TAN Yan-hong 《Chinese Medical Journal》 SCIE CAS CSCD 2012年第17期3177-3179,共3页
Anhidrotic ectodermal dysplasia (EDA) is a relatively rare congenital hereditary disease. Because of a reduced number of sweat glands, patients are unable to perspire and consequently suffer from hyperthermia and in... Anhidrotic ectodermal dysplasia (EDA) is a relatively rare congenital hereditary disease. Because of a reduced number of sweat glands, patients are unable to perspire and consequently suffer from hyperthermia and infection. This is a potential cause of death in childhood. Domestic prenatal diagnosis methods focus on genetic diagnosis. But for some conditions, because of the uncertain molecular pathology, we need other methods to assist to in prenatal diagnosis. Here, we report one case of a new mutation locus which may be associated with EDA and the prenatal diagnosis of EDA by fetal skin biopsy under fetoscopy in mid pregnancy, combined with a review of the literature. 展开更多
关键词 prenatal diagnosis ectodermal dysplasia fetoscopy
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Current Practice and Protocols: Endoscopic Laser Therapy for Twin-Twin Transfusion Syndrome
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作者 Viral M.Pandya Julien Stirnemann +1 位作者 Claire Colmant Yves Ville 《Maternal-Fetal Medicine》 2020年第1期34-47,共14页
The pathophysiology of twin-to-twin transfusion syndrome(TTTS)is complex,and its understanding has evolved along with the evolution and revolution of fetal diagnostic and therapeutic techniques.Over the last few decad... The pathophysiology of twin-to-twin transfusion syndrome(TTTS)is complex,and its understanding has evolved along with the evolution and revolution of fetal diagnostic and therapeutic techniques.Over the last few decades,several therapeutic interventions have been researched for improving the outcomes in TTTS.We present a summary of the current protocols for surveillance,diagnosis,and staging of TTTS in monochorionic pregnancies.We also describe in detail the technique for treatment of TTTS by endoscopic laser photocoagulation. 展开更多
关键词 Fetofetal transfusion fetoscopy Laser photocoagulation Monochorionic twin Twin to twin transfusion syndrome
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