Database : MEDLINE Search on : fetoscopy [Words] References found : 1407 [refine] Displaying: 1 .. 10   in format [Detailed]

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[PMID]: 22441504 [Au] Autor: Rodrigues A; Araújo C; Carvalho R; Melo MA; Pinto L; da Graça LM [Ad] Address: Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital de Santa Maria, Lisbon, Portugal. andreia.dalmeida@gmail.com [Ti] Title: Limb constriction secondary to pseudoamniotic band syndrome after selective fetoscopic laser surgery: report of a case with a favorable outcome. [So] Source: Fetal Diagn Ther;32(4):288-91, 2012. [Is] ISSN: 1421-9964 [Cp] Country of publication: Switzerland [La] Language: eng [Ab] Abstract: Pseudoamniotic band syndrome (PABS) is an iatrogenic complication that causes entanglement of fetal parts in a constrictive sheet of detached or ruptured amniotic membrane after an invasive procedure, namely amniocentesis, amnioreduction or septostomy in twins. The incidence and risk factors for PABS after fetoscopy-guided laser have not been documented [Winer et al.: Am J Obstet Gynecol 2008;198:393.e1-393.e5]. We report a case of monochorionic biamniotic twin pregnancy submitted to selective fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome at 16 weeks of gestation. The procedure was complicated by the death of one of the fetuses at 24 weeks of gestation. Moreover, the surviving twin was diagnosed postnatally with pseudoamniotic band syndrome, presenting with affected limbs. The newborn was submitted to surgical correction of these lesions with a successful outcome and was discharged on day 15. [Mh] MeSH terms primary: Amniotic Band Syndrome/etiology Fetofetal Transfusion/surgery Limb Deformities, Congenital/etiology Pregnancy, Twin [Mh] MeSH terms secundary: Adult Amniotic Band Syndrome/physiopathology Cesarean Section Constriction Female Fetal Death Fetofetal Transfusion/embryology Fetofetal Transfusion/ultrasonography Fetoscopy/adverse effects Humans Infant, Newborn Laser Therapy/adverse effects Light Coagulation/adverse effects Limb Deformities, Congenital/physiopathology Limb Deformities, Congenital/surgery Male Pregnancy Term Birth Treatment Outcome Ultrasonography, Prenatal [Pt] Publication type: CASE REPORTS; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 121211 [St] Status: MEDLINE [do] DOI: 10.1159/000336666

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[PMID]: 23141178 [Au] Autor: Liu XX; Lau Tk; Wang HF; Wong Sm; Leung Ty [Ad] Address: Department of Ultrasound, First Affiliated Hospital of Fujian Medical University, Fuzhou, China. [Ti] Title: [Fetoscopic guided laser occlusion for twin-to-twin transfusion syndrome in 33 cases]. [So] Source: Zhonghua Fu Chan Ke Za Zhi;47(8):587-91, 2012 Aug. [Is] ISSN: 0529-567X [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To evaluate the clinical effect of fetoscopic laser occlusion of chorioangiopagous vessels (FLOC) for monochorionic diamniotic twins (MCDA) pregnancies complicated with twin-to-twin transfusion syndrome(TTTS). METHODS: The clinical data of 33 consecutive cases of TTTS from Mainland China, who had FLOC in the Department of Obstetrics and Gynaecology of Prince of Wales Hospital (The Chinese University of Hong Kong) from November 2003 to December 2010, were reviewed and analyzed for peri-operative complications, perinatal outcomes and fetal survival rate. Clinical stage of TTTS was according to the Quintero staging system. RESULTS: (1) Pregnancy characteristics: the mean maternal age was 30; the median gestational age at FLOC was 23(+4) weeks; according to the Quintero staging system, 3 cases were Quintero staging I, 14 cases were Quintero staging II, 7 cases were Quintero staging III and 9 cases were Quintero staging IV. For the 3 stage I cases, FLOC was performed for severe maternal symptoms of polyhyramnios or severe fetal cardiac dysfunction. (2) Complications: intraoperative complications occurred in 5 patients including four uterine bleedings at the puncture site, one placental vascular anastomosis bleeding. Postoperative complications occurred in 6 patients including 2 abortions and 1 intrauterine death within one week after operation, 2 abortions and 1 amniotic band syndrome occurred from two to four weeks after operation. (3) Perinatal outcome and fetal survival rate: the median interval of 33 patients between FLOC and delivery was 9(+4) weeks; the median gestational age at delivery was 31(+6) weeks; the gestation at delivery was less than 24 weeks in 6% (2/33), 24 to 28 weeks in 21% (7/33), 28 to 32 weeks in 18% (6/33), 32 to 37 weeks in 55% (18/33). The mean birth weight of the donor was 1600 g (350 - 2520 g); the mean birth weight of the recipiert was 1930 g (400 - 3040 g). The overall survival rate, the double infant survival rate, the single survival rate and survival rate for at least one twin was 59% (39/66), 52% (17/33), 15% (5/33) and 67% (22/33), respectively. The overall survival rate dropped from 61% (17/28) in Quintero staging II to 9/18 in Quintero staging IV. CONCLUSIONS: FLOC for MCDA complicated with TTTS is associated with an overall survival of about 60%. Major complications are rare. The outcome is not only related to Quintero staging but also the close monitoring and timely termination of pregnancy. [Mh] MeSH terms primary: Fetofetal Transfusion/surgery Fetoscopy Laser Coagulation/methods Twins, Monozygotic [Mh] MeSH terms secundary: Adult Female Fetofetal Transfusion/mortality Fetofetal Transfusion/pathology Gestational Age Humans Intraoperative Complications/epidemiology Middle Aged Postoperative Complications/epidemiology Pregnancy Pregnancy Complications/mortality Pregnancy Complications/pathology Pregnancy Complications/surgery Pregnancy Outcome Pregnancy Trimester, Second Pregnancy, Twin Retrospective Studies Severity of Illness Index Survival Rate Treatment Outcome Young Adult [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 121112 [St] Status: MEDLINE

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[PMID]: 23055333 [Au] Autor: Carreras E; Arévalo S; Bello-Muñoz JC; Goya M; Rodó C; Sanchez-Duran MA; Peiro JL; Cabero L [Ad] Address: Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain. ecarreras@vhebron.net [Ti] Title: Arabin cervical pessary to prevent preterm birth in severe twin-to-twin transfusion syndrome treated by laser surgery. [So] Source: Prenat Diagn;32(12):1181-5, 2012 Dec. [Is] ISSN: 1097-0223 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: OBJECTIVES: To describe the outcome of patients with twin-to-twin transfusion syndrome and cervical length ≤ 25 mm, treated with laser and an Arabin cervical pessary. METHODS: Retrospective analysis of a consecutive series of all cases with severe twin-to-twin transfusion syndrome who underwent laser surgery: a group with cervical length above 25 mm (group A) and two groups who had a cervical length of 25 mm or less prior to the procedure. The first 8 cases (group B) were managed expectantly and the next 8 cases had a cervical pessary inserted immediately after laser surgery (group C). Gestational age at birth was the primary outcome. The secondary outcome was a composite one encompassing severe neonatal morbidity. RESULTS: The median gestational age at laser surgery was 20 weeks in all groups but the median gestational age at delivery was significantly higher in group C versus B (28 vs 32 weeks, p = 0.01). Severe neonatal morbidity was present in 18% in group C and 70% in group B (p < 0.01). CONCLUSION: Early results suggest a potential role for pessary use in prolonging gestation in cases with shortened cervix at the time of laser. A randomized trial to test this hypothesis should be performed. [Mh] MeSH terms primary: Fetofetal Transfusion/surgery Laser Therapy/methods Pessaries Premature Birth/prevention & control [Mh] MeSH terms secundary: Adult Cervix Uteri/surgery Female Fetofetal Transfusion/epidemiology Fetoscopy/adverse effects Fetoscopy/methods Fetoscopy/statistics & numerical data Humans Infant, Newborn Laser Therapy/adverse effects Laser Therapy/statistics & numerical data Pessaries/utilization Pregnancy Pregnancy Outcome/epidemiology Premature Birth/epidemiology Premature Birth/etiology Premature Birth/surgery Retrospective Studies Severity of Illness Index [Pt] Publication type: COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE [Em] Entry month: 1304 [Js] Journal subset: IM [Da] Date of entry for processing: 121123 [St] Status: MEDLINE [do] DOI: 10.1002/pd.3982

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[PMID]: 22990987 [Au] Autor: Ruano R; da Silva MM; Salustiano EM; Kilby MD; Tannuri U; Zugaib M [Ad] Address: Department of Obstetrics and Gynecology; Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. rodrigoruano@usp.br [Ti] Title: Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review. [So] Source: Prenat Diagn;32(12):1127-32, 2012 Dec. [Is] ISSN: 1097-0223 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: OBJECTIVE: To evaluate the perinatal outcomes in hydropic fetuses with congenital microcystic pulmonary lesions that underwent percutaneous, invasive, laser therapy. METHOD: This retrospective study reviews the literature and our experience between 2004 and 2010. Characteristics of the cystic lung lesions, liquor volume (presence of polyhydramnios or not), localization of ablation (vascular vs interstitial) and gestational age at which the procedure was performed were related to outcome (survival). RESULTS: In total, 16 fetuses with congenital lung lesions underwent 'invasive' percutaneous laser ablation, seven performed in our center and nine published cases. Survival rate was higher in fetuses with a subsequent postnatal diagnosis of bronchopulmonary sequestration (87.5%) compared with congenital adenomatoid malformation (28.6%; p = 0.04). The technique of vascular ablation was more successful (100%) than interstitial ablation (25.0%, p < 0.01). CONCLUSION: Percutaneous vascular laser ablation seems to be effective for bronchopulmonary sequestration in hydropic fetuses. Outcomes were worst following interstitial ablation for microcystic congenital adenomatoid with hydrops. [Mh] MeSH terms primary: Cystic Adenomatoid Malformation of Lung, Congenital/surgery Hydrops Fetalis/surgery Laser Therapy/methods Ultrasonography, Interventional/methods Ultrasonography, Prenatal/methods [Mh] MeSH terms secundary: Adult Bronchopulmonary Sequestration/surgery Bronchopulmonary Sequestration/ultrasonography Cohort Studies Cystic Adenomatoid Malformation of Lung, Congenital/ultrasonography Female Fetoscopy/methods Humans Hydrops Fetalis/ultrasonography Infant, Newborn Models, Biological Pregnancy Retrospective Studies [Pt] Publication type: EVALUATION STUDIES; JOURNAL ARTICLE; REVIEW [Em] Entry month: 1304 [Js] Journal subset: IM [Da] Date of entry for processing: 121123 [St] Status: MEDLINE [do] DOI: 10.1002/pd.3969

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[PMID]: 22631591 [Au] Autor: Sosa-Sosa C; Bermúdez C; Chmait RH; Kontopoulos E; Córdoba Y; Guevara-Zuloaga F; Steffensen T; Quintero RA [Ad] Address: Instituto Venezolano de Investigaciones Científicas (IVIC), Altos de Pipe, Estado Miranda, Venezuela. [Ti] Title: Intraluminal tracheal occlusion using a modified 8-mm Z-stent in a sheep model of left-sided congenital diaphragmatic hernia. [So] Source: J Matern Fetal Neonatal Med;25(11):2346-53, 2012 Nov. [Is] ISSN: 1476-4954 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: OBJECTIVE: To evaluate pulmonary growth and development after fetoscopic intraluminal tracheal occlusion (FITO) using a modified 8-mm Z-stent in an ovine model of congenital left-sided diaphragmatic hernia (CDH). METHODS: Thirty-three time-dated ewes were studied: Group I: healthy controls; Group II: CDH controls (untreated); Group III: CDH treated with FITO. CDH was created in Groups II and III at 70-80 days' gestation. FITO was performed at 100-110 days. Left lung histological, morphometric, immunohistochemical and biochemical studies were conducted after delivery and euthanasia at 138 days. RESULTS: Fifteen (45%) animals (Group I: 3; Group II: 5; Group III: 7) were available for analysis. The left lung parenchymal volume to fetal weight ratios were similar between Groups I and III (p = 0.24), and higher than Group II (p < 0.05III (79 versus 75%, p = 0.26), compared to 41% in Group II (p < 0.05). Pulmonary hypoplasia occurred in 1/7 (16%) in the FITO group, compared to 100% in Group II and 0% in Group I (p = .003). DNA and protein were significantly increased in Group III (p < 0.001). The concentration of type II pneumocytes was similar between healthy controls and the FITO group, and was paradoxically increased in untreated hernia fetuses. There was no histological evidence of tracheal injury. CONCLUSION: FITO with a modified 8-mm Z-stent is associated with lung growth and maturation similar to controls without obvious deleterious effects. A phase I clinical trial of FITO with the modified 8-mm Z-stent in severe CDH patients seems warranted. [Mh] MeSH terms primary: Fetoscopy/methods Hernia, Diaphragmatic/congenital Stents Therapeutic Occlusion/methods Trachea/surgery [Mh] MeSH terms secundary: Animals Disease Models, Animal Female Fetal Organ Maturity/physiology Fetoscopy/veterinary Functional Laterality Gestational Age Hernia, Diaphragmatic/pathology Hernia, Diaphragmatic/surgery Lung/cytology Lung/embryology Lung/pathology Pregnancy Sheep, Domestic Trachea/pathology [Pt] Publication type: COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Entry month: 1304 [Js] Journal subset: IM [Da] Date of entry for processing: 121015 [St] Status: MEDLINE [do] DOI: 10.3109/14767058.2012.695825

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[PMID]: 22631227 [Au] Autor: Quintero RA; Kontopoulos E; Reiter J; Pedreira WL; Colin AA [Ad] Address: Division of Fetal Therapy, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. rquintero@med.miami.edu [Ti] Title: Fetal bronchoscopy: its successful use in a case of extralobar pulmonary sequestration. [So] Source: J Matern Fetal Neonatal Med;25(11):2354-8, 2012 Nov. [Is] ISSN: 1476-4954 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: OBJECTIVE: To report the performance of fetal bronchoscopy in a case of pulmonary sequestration. MATERIALS AND METHODS: A 24 year-old female, Gravida 2, Para 1, was referred at 27.5 weeks with a large fetal left lung mass with marked right mediastinal shift and no visible normal left lung. Differential diagnosis included possible bronchial atresia. RESULTS: The patient underwent fetal laryngoscopy and fetal bronchoscopy at 31.5 weeks. The right lung and a portion of the left lung expanded during surgery as a result of bronchial lavage. Bronchial atresia or bronchogenic cyst were not found. Pregnancy continued uneventfully, with continuous growth of the right lung and a small amount of left lung. The patient delivered vaginally at term. The baby underwent thoracoscopic resection of a pulmonary sequestration at 10.5 months of age and did well. CONCLUSION: Fetal bronchoscopy is feasible. The procedure may prove useful in the differential diagnosis and in the potential treatment of different fetal lung lesions, as well as aid in the understanding of the role of bronchial obstruction as a common pathophysiologic mechanism for different fetal lung masses. Risks and benefits of fetal bronchoscopy warrant further experience. [Mh] MeSH terms primary: Bronchopulmonary Sequestration/therapy Bronchoscopy/methods Fetal Diseases/surgery Fetoscopy/methods [Mh] MeSH terms secundary: Bronchopulmonary Sequestration/diagnosis Diagnosis, Differential Female Fetal Diseases/diagnosis Fetus/surgery Humans Pregnancy Treatment Outcome Young Adult [Pt] Publication type: CASE REPORTS; JOURNAL ARTICLE [Em] Entry month: 1304 [Js] Journal subset: IM [Da] Date of entry for processing: 121015 [St] Status: MEDLINE [do] DOI: 10.3109/14767058.2012.695826

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[PMID]: 23201086 [Au] Autor: Kuller JA; Norton ME [Ti] Title: Expanding the gestational age limits for laser treatment for twin-twin transfusion. [So] Source: Am J Obstet Gynecol;208(3):165-6, 2013 Mar. [Is] ISSN: 1097-6868 [Cp] Country of publication: United States [La] Language: eng [Mh] MeSH terms primary: Fetofetal Transfusion/surgery Fetoscopy/methods Laser Therapy/methods [Mh] MeSH terms secundary: Female Humans Pregnancy [Pt] Publication type: COMMENT; EDITORIAL [Em] Entry month: 1304 [Js] Journal subset: AIM; IM [Da] Date of entry for processing: 130225 [St] Status: MEDLINE

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[PMID]: 23178244 [Au] Autor: Baud D; Windrim R; Keunen J; Kelly EN; Shah P; van Mieghem T; Seaward PG; Ryan G [Ad] Address: Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. [Ti] Title: Fetoscopic laser therapy for twin-twin transfusion syndrome before 17 and after 26 weeks' gestation. [So] Source: Am J Obstet Gynecol;208(3):197.e1-7, 2013 Mar. [Is] ISSN: 1097-6868 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: OBJECTIVE: The purpose of this study was to compare perinatal outcomes of pregnancies that undergo "early" (<17 weeks' gestation) or "late" (>26 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with "conventional" cases that were treated at 17-26 weeks' gestation. STUDY DESIGN: We conducted a single center, retrospective analysis of 325 consecutive pregnancies that underwent fetoscopic laser therapy for severe TTTS. RESULTS: Twenty-four "early," 18 "late," and 283 "conventional" pregnancies with severe TTTS underwent laser therapy. Fetoscopy duration, gestation at delivery, survival rate, and complications were comparable among groups, except for preterm premature rupture of membranes at <7 days after laser therapy, which was more common in the "early" group than in either of the other 2 groups. CONCLUSION: Laser therapy for TTTS at <17 or >26 weeks' gestation has similar outcomes to procedures done at 17-26 weeks' gestation. We suggest that conventional gestational age guidelines of 16-26 weeks for laser therapy for TTTS should be reevaluated. [Mh] MeSH terms primary: Fetofetal Transfusion/surgery Fetoscopy/methods Laser Therapy/methods [Mh] MeSH terms secundary: Adolescent Adult Female Gestational Age Humans Middle Aged Pregnancy Pregnancy Trimester, Second Pregnancy Trimester, Third Retrospective Studies Treatment Outcome [Pt] Publication type: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Entry month: 1304 [Js] Journal subset: AIM; IM [Da] Date of entry for processing: 130225 [St] Status: MEDLINE

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[PMID]: 23021698 [Au] Autor: Vanderbilt DL; Schrager SM; Llanes A; Chmait RH [Ad] Address: Division of General Pediatrics, Department of Pediatrics, Keck School of Medicin, University of Southern California, Los Angeles, CA, USA. [Ti] Title: Prevalence and risk factors of cerebral lesions in neonates after laser surgery for twin-twin transfusion syndrome. [So] Source: Am J Obstet Gynecol;207(4):320.e1-6, 2012 Oct. [Is] ISSN: 1097-6868 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: OBJECTIVE: To identify risk factors for cerebral lesions among survivors of twin-twin transfusion syndrome treated with laser surgery. STUDY DESIGN: A multilevel regression analysis examined risk factors for neonatal cerebral lesions identified by imaging. Imaging was routine in "high-risk survivors," defined as those delivered at <32 weeks' gestation, and by clinical indications if born later. Severe lesions were defined as: intraventricular hemorrhage grade III-IV, cystic periventricular leukomalacia, ventriculomegaly and/or hydrocephalus, microcephaly, infarctions, porencephalic/Dandy-Walker cysts, or bilateral other cysts. RESULTS: For 262 consecutive laser-treated twin-twin transfusion syndrome patients, 18 neonates had severe lesions identified among 427 individual survivors (4.2%) and 242 "high-risk survivors" (7.4%). Forty-six newborns had any cerebral lesion, resulting in lesion rates of 10.8%-19.0%. Delivery <32 weeks' (odds ratio, 4.95; P < .001) and <28 weeks' (odds ratio, 6.25; P < .001) gestation were associated with increased likelihood of any cerebral lesion. CONCLUSION: This cohort showed low rates (4-7%) of severe neonatal cerebral lesions, with prematurity being the primary risk factor. [Mh] MeSH terms primary: Fetofetal Transfusion/surgery Hydrocephalus/etiology Intracranial Hemorrhages/etiology Laser Therapy/adverse effects Leukomalacia, Periventricular/etiology [Mh] MeSH terms secundary: Female Fetoscopy/adverse effects Humans Hydrocephalus/epidemiology Infant, Newborn Infant, Premature Intracranial Hemorrhages/epidemiology Leukomalacia, Periventricular/epidemiology Pregnancy Prevalence Risk Factors [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1212 [Cu] Class update date: 130416 [Lr] Last revision date: 130416 [Js] Journal subset: AIM; IM [Da] Date of entry for processing: 121001 [St] Status: MEDLINE

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[PMID]: 22682379 [Au] Autor: Saadai P; Farmer DL [Ad] Address: Division of Pediatric Surgery, Department of Surgery, Fetal Treatment Center, University of California, San Francisco, 513 Parnassus Avenue, HSW 16-01, Box 0570, San Francisco, CA 94143-0570, USA. payam.saadai@ucsfmedctr.org [Ti] Title: Fetal surgery for myelomeningocele. [So] Source: Clin Perinatol;39(2):279-88, 2012 Jun. [Is] ISSN: 1557-9840 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: Myelomeningocele (MMC) is a congenital neural tube defect that occurs in approximately 1 in 2900 live births in the United States. It is a devastating disability with significant morbidity and mortality within the first few decades of life. MMC was the first nonlethal disease to be considered and studied for fetal surgery and is now the most common open fetal surgery performed. The recently completed MOMS randomized controlled trial has shown that fetal repair for MMC can improve hydrocephalus and hindbrain herniation, can reduce the need for vetriculoperitoneal shunting, and may improve distal neurologic function in some patients. [Mh] MeSH terms primary: Fetoscopy/methods Fetus/surgery Hydrocephalus/surgery Meningomyelocele/surgery Pregnancy Complications/surgery Ventriculoperitoneal Shunt [Mh] MeSH terms secundary: Female Fetal Diseases/surgery Fetus/physiopathology Humans Meningomyelocele/physiopathology Pregnancy Treatment Outcome [Pt] Publication type: JOURNAL ARTICLE; REVIEW [Em] Entry month: 1301 [Cu] Class update date: 130416 [Lr] Last revision date: 130416 [Js] Journal subset: IM [Da] Date of entry for processing: 120611 [St] Status: MEDLINE [do] DOI: 10.1016/j.clp.2012.04.003

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