Fetoscopy Role in Fetal Surgery and Fetal Medicine

Abstract

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.