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Chapter 45 - Open Neural Tube Defect Repair: Development and Refinement of a Fetoscopic Technique

from Surgical Correction of Neural Tube Anomalies

Published online by Cambridge University Press:  21 October 2019

By
Michael A. Belfort ,
Alireza A. Shamshirsaz  and
William E. Whitehead
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
University of Birmingham
Anthony Johnson
Affiliation:
University of Texas Medical School at Houston
Dick Oepkes
Affiliation:
Leids Universitair Medisch Centrum
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Summary

Fetal surgery has evolved over the last three decades from an innovative and ambitious concept into an accepted reality. The metamorphosis from curiosity to sought-after therapy has been driven by the refinement of techniques used in open hysterotomy surgeries, advances in the available technology and instrumentation, expansion of the repertoire of minimally invasive image-guided percutaneous interventions, and the development of safe and effective fetoscopic surgical procedures. Serious complications associated with the early era fetal surgery procedures such as intraoperative fetal death, abruptio placentae and pulmonary edema have been largely eliminated, and extreme preterm delivery (<28 weeks) has been significantly reduced. Specialized anesthesia protocols and intraoperative management algorithms have led to improved fetal tolerance of these procedures, and advancements in neonatal intensive care have dramatically improved neonatal outcomes.

Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 467 - 479
Publisher: Cambridge University Press
Print publication year: 2020

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