Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-28T22:35:20.800Z Has data issue: false hasContentIssue false

Foreword

Published online by Cambridge University Press:  05 February 2013

Charles H. Rodeck
Affiliation:
University College London
Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
Get access

Summary

Foreword

The history of fetal medicine has run a disorderly course, lacking in synchronicity. A landmark date is 1963, when William Liley published the first example of direct fetal therapy, intra-peritoneal blood transfusion for rhesus alloimmunization. This was long before the ultrasound technology that we regard as a sine qua non, and that we take for granted, was available. How much safer and more effective would the procedure have been with ultrasound guidance, at a time when hemolytic disease of the fetus was fairly common. Not long afterwards, rhesus porphylaxis was introduced and the condition became less frequent, just as its treatment with intravascular transfusion improved. It has now become so rare that it is difficult to provide training and to maintain skills.

Since then, there have been revolutions not only in ultrasound, but also in the laboratory sciences of biochemistry, cell culture, genetics, and molecular biology. These were embraced by fetal medicine, first for diagnosis and then for population screening and prevention of fetal conditions. Overwhelmingly, these are the main pre-occupations of fetal medicine and take place in all hospitals in the context of antenatal care. Fetal therapy has represented a far smaller area of activity (although the love affair of the media for fetal surgery might make one think otherwise!). h e reasons for this include the complexity and formidable nature of some of the interventions, the relatively rare indications and opportunities for performing them, and the limited availability of the necessary skills and facilities. The accumulation of knowledge and experience has therefore been slow and rightly has been restricted to highly specialized centers. There is, as yet, no definitive treatment for genetic disease, pre- or postnatally, and the understanding of the molecular basis for malformations is insufficiently advanced to design preventive strategies.

Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
, pp. xiii - xiv
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×