Fetoscopy and Fetal Surgery
Fetoscopy is a high-tech intervention performed strictly in the operating room under anesthesia. All manipulations are carried out under mandatory additional ultrasound guidance.
- Indications: presence of amniotic bands, twin-to-twin transfusion syndrome, acardiac twin, or malformations of one of the fetuses in a monochorionic twin pregnancy.
- Capabilities: division of bands, coagulation of the umbilical cord or placental anastomoses.
- Complications: the main risks are premature rupture of membranes and pregnancy loss.
Amniocentesis and Fluid Analysis
Amniocentesis involves obtaining amniotic fluid for genetic, biochemical, or cytological analysis. The procedure is performed through the anterior abdominal wall under ultrasound guidance after local anesthesia.
- The physician collects 10–15 ml of fluid, avoiding blood or meconium contamination.
- The only absolute contraindication to the manipulation is the threat of miscarriage.
- The obtained fluid is also used to assess fetal lung maturity via the lecithin/sphingomyelin ratio and the foam stability test.
Cordocentesis
Cordocentesis is a method of directly obtaining fetal blood by puncturing the umbilical cord vessels. The study is predominantly performed after 18–20 weeks of gestation.
- Diagnostic objectives: karyotyping to detect hereditary diseases, diagnosis of intrauterine infections, anemia, and hypoxia.
- Therapeutic objectives: performing intrauterine therapy, including intravascular blood transfusion for hemolytic disease of the fetus.
Class and exam questions
What are the indications for amniocentesis?
Amniocentesis is prescribed for isospecific blood incompatibility, chronic hypoxia, the need for karyotyping to rule out genetic pathology, determination of fetal maturity and sex, as well as for microbiological examination.
What are the main risks of fetoscopy?
The main complications of fetoscopy include premature rupture of membranes and pregnancy loss. Bleeding and infectious processes are extremely rare.
What is evaluated during amniotic fluid analysis to determine lung maturity?
The main marker of pulmonary tissue maturity is the lecithin-to-sphingomyelin ratio. A value of 2:1 or higher indicates lung maturity and minimal risk of respiratory distress syndrome.
What else to study on this topic
- Amnioscopy and assessment of amniotic fluid color
- Maternal blood laboratory markers (hCG, PAPP-A, AFP)
- X-ray pelvimetry and assessment of the bony pelvis
- Capabilities of magnetic resonance imaging in obstetrics
- Neonatal neurosonography
Master the entire topic in the "Obstetrics and Gynecology" course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "Invasive Prenatal Diagnostic Methods" and 973 more pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 21 video lessons on the subject
Other topics in the "Obstetrics" section
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.