INTRAUTERINE FETAL VISUALIZATION: A MULTIDISCIPLINARY APPROACH

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Prenatal fetoscopy is an exciting concept if it can be made safe for the fetus in question. It is a perplexing problem that routine amniocentesis can be performed with a 20 gauge needle and offer little, if any, observable fetal morbidity or mortality. It would, therefore, seem that an instrument slightly larger than a 20 gauge needle could be utilized to visualize the fetus and possibly obtain small biopsies for laboratory analysis. The advantages to the prenatal birth defect effort are obvious. Such a capability would allow the growth in tissue culture of cells from the fetus to be virtually 100% successful as one would be dealing with fresh tissue from a biopsy rather than relying on desquamated cells in the amnionic fluid. In addition, fetal red cells could be obtained for prenatal diagnosis of hematologic disorders. Valenti has sampled fetal red cells using an 18 French fetoscope in patients undergoing immediate abortion after the procedure. It is difficult to find data on the long term effects of fetoscopy upon the human fetus. One case of fetoscopy prior to 24 weeks that went to term, but required hospitalization for persistent leakage of amnionic fluid was recently reported in Lancet by Laurence in Wales. He has performed the procedure in 12 other patients who were immediately aborted. Needless to say, the results of this initial study were discouraging in that all 5 fetuses expired within 6 days of fetoscopy. It appears that there is a direct relationship between morbidity and the size of the instrument utilized for fetoscopy. It appears that if this procedure is to be successful in the future, an instrument must be devised that is probably no larger in diameter than a 16 gauge needle. The optical physics of such a device would be extremely difficult. However, if fetoscopy is to become a useful procedure it must carry a morbidity and mortality to the fetus that would be less than the congenital disorder under investigation. The next step in this procedure must remain with the bio optical engineers in designing an instrument that would be as small as possible in diameter, yet would allow visual acuity, plus the ability to sample fetal skin or blood. After such instruments are devised, the above experiments should be repeated on patients desiring therapeutic abortion and hysterectomy prior to institution of this procedure in a prenatal birth defects clinic.

Original languageEnglish (US)
Title of host publicationEXCERPTA MED., AMSTERDAM, I.C.S.
Pages184-190
Number of pages7
Volumeno.371
StatePublished - 1976

Fingerprint

Fetoscopy
Fetus
Needles
Morbidity
Fetoscopes
Therapeutic Abortion
Biopsy
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Aptitude
Amniocentesis
Mortality
Wales
Physics
Prenatal Diagnosis
Hysterectomy
Visual Acuity
Hospitalization
Cell Culture Techniques
Equipment and Supplies
Skin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wheeless, C. R. (1976). INTRAUTERINE FETAL VISUALIZATION: A MULTIDISCIPLINARY APPROACH. In EXCERPTA MED., AMSTERDAM, I.C.S. (Vol. no.371, pp. 184-190)

INTRAUTERINE FETAL VISUALIZATION : A MULTIDISCIPLINARY APPROACH. / Wheeless, Clifford R.

EXCERPTA MED., AMSTERDAM, I.C.S.. Vol. no.371 1976. p. 184-190.

Research output: Chapter in Book/Report/Conference proceedingChapter

Wheeless, CR 1976, INTRAUTERINE FETAL VISUALIZATION: A MULTIDISCIPLINARY APPROACH. in EXCERPTA MED., AMSTERDAM, I.C.S.. vol. no.371, pp. 184-190.
Wheeless CR. INTRAUTERINE FETAL VISUALIZATION: A MULTIDISCIPLINARY APPROACH. In EXCERPTA MED., AMSTERDAM, I.C.S.. Vol. no.371. 1976. p. 184-190
Wheeless, Clifford R. / INTRAUTERINE FETAL VISUALIZATION : A MULTIDISCIPLINARY APPROACH. EXCERPTA MED., AMSTERDAM, I.C.S.. Vol. no.371 1976. pp. 184-190
@inbook{14e2dbb76b0e417c961bd6a7fedb6b39,
title = "INTRAUTERINE FETAL VISUALIZATION: A MULTIDISCIPLINARY APPROACH",
abstract = "Prenatal fetoscopy is an exciting concept if it can be made safe for the fetus in question. It is a perplexing problem that routine amniocentesis can be performed with a 20 gauge needle and offer little, if any, observable fetal morbidity or mortality. It would, therefore, seem that an instrument slightly larger than a 20 gauge needle could be utilized to visualize the fetus and possibly obtain small biopsies for laboratory analysis. The advantages to the prenatal birth defect effort are obvious. Such a capability would allow the growth in tissue culture of cells from the fetus to be virtually 100{\%} successful as one would be dealing with fresh tissue from a biopsy rather than relying on desquamated cells in the amnionic fluid. In addition, fetal red cells could be obtained for prenatal diagnosis of hematologic disorders. Valenti has sampled fetal red cells using an 18 French fetoscope in patients undergoing immediate abortion after the procedure. It is difficult to find data on the long term effects of fetoscopy upon the human fetus. One case of fetoscopy prior to 24 weeks that went to term, but required hospitalization for persistent leakage of amnionic fluid was recently reported in Lancet by Laurence in Wales. He has performed the procedure in 12 other patients who were immediately aborted. Needless to say, the results of this initial study were discouraging in that all 5 fetuses expired within 6 days of fetoscopy. It appears that there is a direct relationship between morbidity and the size of the instrument utilized for fetoscopy. It appears that if this procedure is to be successful in the future, an instrument must be devised that is probably no larger in diameter than a 16 gauge needle. The optical physics of such a device would be extremely difficult. However, if fetoscopy is to become a useful procedure it must carry a morbidity and mortality to the fetus that would be less than the congenital disorder under investigation. The next step in this procedure must remain with the bio optical engineers in designing an instrument that would be as small as possible in diameter, yet would allow visual acuity, plus the ability to sample fetal skin or blood. After such instruments are devised, the above experiments should be repeated on patients desiring therapeutic abortion and hysterectomy prior to institution of this procedure in a prenatal birth defects clinic.",
author = "Wheeless, {Clifford R.}",
year = "1976",
language = "English (US)",
volume = "no.371",
pages = "184--190",
booktitle = "EXCERPTA MED., AMSTERDAM, I.C.S.",

}

TY - CHAP

T1 - INTRAUTERINE FETAL VISUALIZATION

T2 - A MULTIDISCIPLINARY APPROACH

AU - Wheeless, Clifford R.

PY - 1976

Y1 - 1976

N2 - Prenatal fetoscopy is an exciting concept if it can be made safe for the fetus in question. It is a perplexing problem that routine amniocentesis can be performed with a 20 gauge needle and offer little, if any, observable fetal morbidity or mortality. It would, therefore, seem that an instrument slightly larger than a 20 gauge needle could be utilized to visualize the fetus and possibly obtain small biopsies for laboratory analysis. The advantages to the prenatal birth defect effort are obvious. Such a capability would allow the growth in tissue culture of cells from the fetus to be virtually 100% successful as one would be dealing with fresh tissue from a biopsy rather than relying on desquamated cells in the amnionic fluid. In addition, fetal red cells could be obtained for prenatal diagnosis of hematologic disorders. Valenti has sampled fetal red cells using an 18 French fetoscope in patients undergoing immediate abortion after the procedure. It is difficult to find data on the long term effects of fetoscopy upon the human fetus. One case of fetoscopy prior to 24 weeks that went to term, but required hospitalization for persistent leakage of amnionic fluid was recently reported in Lancet by Laurence in Wales. He has performed the procedure in 12 other patients who were immediately aborted. Needless to say, the results of this initial study were discouraging in that all 5 fetuses expired within 6 days of fetoscopy. It appears that there is a direct relationship between morbidity and the size of the instrument utilized for fetoscopy. It appears that if this procedure is to be successful in the future, an instrument must be devised that is probably no larger in diameter than a 16 gauge needle. The optical physics of such a device would be extremely difficult. However, if fetoscopy is to become a useful procedure it must carry a morbidity and mortality to the fetus that would be less than the congenital disorder under investigation. The next step in this procedure must remain with the bio optical engineers in designing an instrument that would be as small as possible in diameter, yet would allow visual acuity, plus the ability to sample fetal skin or blood. After such instruments are devised, the above experiments should be repeated on patients desiring therapeutic abortion and hysterectomy prior to institution of this procedure in a prenatal birth defects clinic.

AB - Prenatal fetoscopy is an exciting concept if it can be made safe for the fetus in question. It is a perplexing problem that routine amniocentesis can be performed with a 20 gauge needle and offer little, if any, observable fetal morbidity or mortality. It would, therefore, seem that an instrument slightly larger than a 20 gauge needle could be utilized to visualize the fetus and possibly obtain small biopsies for laboratory analysis. The advantages to the prenatal birth defect effort are obvious. Such a capability would allow the growth in tissue culture of cells from the fetus to be virtually 100% successful as one would be dealing with fresh tissue from a biopsy rather than relying on desquamated cells in the amnionic fluid. In addition, fetal red cells could be obtained for prenatal diagnosis of hematologic disorders. Valenti has sampled fetal red cells using an 18 French fetoscope in patients undergoing immediate abortion after the procedure. It is difficult to find data on the long term effects of fetoscopy upon the human fetus. One case of fetoscopy prior to 24 weeks that went to term, but required hospitalization for persistent leakage of amnionic fluid was recently reported in Lancet by Laurence in Wales. He has performed the procedure in 12 other patients who were immediately aborted. Needless to say, the results of this initial study were discouraging in that all 5 fetuses expired within 6 days of fetoscopy. It appears that there is a direct relationship between morbidity and the size of the instrument utilized for fetoscopy. It appears that if this procedure is to be successful in the future, an instrument must be devised that is probably no larger in diameter than a 16 gauge needle. The optical physics of such a device would be extremely difficult. However, if fetoscopy is to become a useful procedure it must carry a morbidity and mortality to the fetus that would be less than the congenital disorder under investigation. The next step in this procedure must remain with the bio optical engineers in designing an instrument that would be as small as possible in diameter, yet would allow visual acuity, plus the ability to sample fetal skin or blood. After such instruments are devised, the above experiments should be repeated on patients desiring therapeutic abortion and hysterectomy prior to institution of this procedure in a prenatal birth defects clinic.

UR - http://www.scopus.com/inward/record.url?scp=0017064278&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017064278&partnerID=8YFLogxK

M3 - Chapter

AN - SCOPUS:0017064278

VL - no.371

SP - 184

EP - 190

BT - EXCERPTA MED., AMSTERDAM, I.C.S.

ER -