Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ INTRODUCTION ++ Definitions Bipolar cord cautery: a percutaneous ultrasound-guided technique with endoscopic evaluation capability that introduces a 3.0-mm bipolar cautery device through a 4.0-mm trocar sheath, and with ultrasound guidance, the umbilical cord is grasped between the bipolar device's "jaws" and 60 to 100 W of power is applied in 2 to 3 sites to obtain cord/vascular occlusion with absence of umbilical cord blood flow documented by Doppler evaluation; endoscopic visualization of the cord cautery sites can be undertaken as well, but complete occlusion can not be confirmed visually. Congenital anomalies/birth defect terminology: Deformation: a mechanical force that interferes with a normally developing process causing a shape/positioning abnormality of a fetal organ or body part (pulmonary hypoplasia secondary to congenital diaphragmatic hernia or pleural effusions, or congenital adenomatoid malformations or early onset prolonged oligohydramnios). Disruption: a teratogenic event or destructive insult (vascular, infectious, metabolic, drug) that interferes with a normally developing process causing an abnormal structural/developmental outcome of a fetal organ or body part (recipient cardiac pathology in twin-to-twin transfusion syndrome, cerebral ventriculomegaly secondary to viral or germinal matrix hemorrhage with neuronal loss). Dysplasia/aplasia/hypoplasia: pathologic disorganization of the cell structure itself or disorganized cells within the tissue or tissues within a particular structure to create a structural anomaly; absence of a tissue or an organ due to absent cellular proliferation; insufficient cellular proliferation leading to undergrowth (renal dysplasia, renal agenesis, renal hypoplasia). Malformation: primary structural/developmental disorganization of a fetal organ or body part (congenital heart disease, myelomeningocele, sacrococcygeal teratoma, urethral obstruction) usually prior to embryonic week 8. Endoscopic laser coagulation: following initial ultrasound evaluation with placental/umbilical cord insertion "mapping," this percutaneous ultrasound-guided technique introduces a 2.0-mm fiberoptic endoscope into the uterine cavity under local anesthesia or with conscious maternal sedation to examine and identify placental surface vascular anastomoses between monochorionic twins with twin-to-twin transfusion syndrome; anastomoses are then selectively interrupted by laser coagulation creating a "surgical" dichorionic placenta. EXIT delivery: ex utero intrapartum treatment (EXIT) was initially designed for reversal of tracheal occlusion performed in fetuses with severe diaphragmatic hernias; this delivery strategy ensures an optimal controlled environment with the fetus on uteroplacental bypass allowing fetal surgery of the neck and thorax for 50 to 70 minutes. Maternal–fetal surgery: fetal therapy that requires maternal laparotomy and hysterotomy to obtain access to the fetus with resulting increased maternal and fetal risk. Radiofrequency ablation: a percutaneous ultrasound-guided technique that allows the 2- to 3-mm radiofrequency device to be placed at the correct vascular/tissue location to then create increased temperature changes by high-frequency alternating current between the electrodes in the vascular/tissue location causing coagulation, tissue desiccation, and vascular occlusion as assessed by Doppler evaluation. Thoracoamniotic shunt: a unidirectional fluid flow "pigtailed" shunt, which is inserted with one end in the fluid-filled chest location and the other end in the amniotic fluid space placed under percutaneous ultrasound guidance; this allows the drainage of the chest fluid into ... GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. What is MyAccess? Create a FREE MyAccess profile to: Use this site remotely Bookmark your favorite content Track your self-assessment progress and more!