Surgery on the fetus, is it possible?

Surgery on the fetus, is it possible?
All parents must have wanted the condition of the fetus is healthy and will be born with perfect health. But there are times when the fetus does not grow normally properly. The condition can be caused by abnormalities in the fetus due to maternal age during pregnancy, paternal age is also slightly affected, the mother-father genetic abnormalities, incompatibilities maternal and fetal blood, maternal infection before and during pregnancy, and fetal congenital abnormalities.

Invasive action aims to ensure the health condition of the fetus (screening) or correct (therapy) abnormalities or disease in the fetus.

Some measures that can be done is

  1. Chorionic villus sampling (CVS). Action by taking a sample of fetal placenta (chorionic villus) at 11-16 weeks of gestation. Action using a small tube is inserted through the cervix and take a bit of fetal placenta.
  2. Amniocentesis. Act of taking a sample of amniotic fluid is the fetus at 16 weeks gestation. Actions performed by injecting a needle in the mother's abdomen into the amniotic cavity with usg guidance (ultrasound guided).
  3. Fetal blood sampling during labor (Fetal blood sampling). The act aims to determine the condition of the fetus is experiencing fetal distress during labor. Injection performed on the fetal head to take blood samples and performed the examination pHdarah fetus (seen in blood acidity / acidosis)
  4. Kordosintesis. The act of taking blood samples of fetuses in the umbilical cord to the fetus through the abdominal wall puncture ibu.Tindakan performed at 18-24 weeks of gestation. Usually done when CVS or amniocentesis obtained unsatisfactory results. Aiming to find out if there are fetal abnormalities, chromosomal abnormalities, fetal blood, fetal anemia, fetal infections (toxoplasmosis) and even to treat the fetus is abnormal heart rhythms (antiarrhythmic drug injection).
  5. Fetal blood transfusion. Measures taken to increase levels of iron (hemoglobin) fetuses had severe anemia because of abnormalities of the fetal blood. (Usually due to maternal blood rhesus factors that do not correspond to the fetus (Rh incompatibility) or the presence of parvovirus B19 infection
  6. Feto-amniotic shunting. Fetal surgery to correct abnormalities in the fetus. Action by installing a drain hose for a particular kind of abnormal fluid in the body cavity of the fetus. For example the fluid in the fetal chest cavity (hidrotorak), abnormalities in fetal lung adenoma cysts (cystic adenomatoid malformation of the lung) urinary tract obstruction in the fetus (infravesical stenosis) and presence of fluid in the fetal abdomen (fetal ascites).
  7. Open fetal surgery (open fetal surgery) done to correct abnormalities of the fetus. Can be done openly (dissected maternal abdominal wall and the wall of the uterus, the fetus is removed partially or completely, then correction of abnormalities found. Or when it can be done using binoculars (minimally-invasive fetoscopic surgery (also known as Fetendo) by inserting a pair of binoculars associated with the camera so that it can be seen through the TV by a surgeon.

Open fetal surgery can be done:

  • Closing the gap in the diaphragm chest cavity which causes the gut into the chest cavity that interfere with the heart and lungs. (Congenital diaphragmatic hernia)
  • Treating cysts in the fetal lung abnormalities (Congenital cystic adenomatoid malformation)
  • Correcting congenital fetal heart abnormalities (Congenital heart disease)
  • Closing the gap in the spine that cause nerve membrane and the bone marrow out. (Myelomeningocele)
  • Corrects abnormalities in the lungs (pulmonary sequestration)
  • Correcting the tail bone tumors in the fetus (Sacrococcygeal teratoma)
  • Closing the gap in the backbone of the fetus in cases of Spina bifida

Fetoscopy actions that can be done:

  • Arson / ablation of fetal blood vessels in the placenta in twin fetuses with abnormalities of the Twin-twin transfusion syndrome.
  • Corrects obstruction in the fetal bladder by placing a shunt in cases of Fetal bladder obstructions
  • Correct the fetal heart valve to improve blood flow (aortic or pulmonary Valvuloplasty)
  • Make a hole in the wall of the heart to drain blood (Atrial Septostomy)
  • Inserting a balloon in the fetal esophagus so that the fetus can survive (Balloon tracheal occlusion) in congenital diaphragmatic hernia disorders
  • Closing the gap in the backbone of the fetus at the Spina Bifida

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