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
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
文摘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.
文摘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).
