RT Book, Section
A1 Wilson, R. Douglas
A2 Fleischer, Arthur C.
A2 Toy, Eugene C.
A2 Lee, Wesley
A2 Manning, Frank A.
A2 Romero, Roberto J.
SR Print(0)
ID 1106709501
T1 FETAL THERAPY: MATERNAL FETAL SURGERY AND PERCUTANEOUS ULTRASOUND GUIDED FETAL THERAPY TECHNIQUES FOR CONGENITAL ANOMALIES
T2 Sonography in Obstetrics and Gynecology: Principles & Practice, 7e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071547727
LK obgyn.mhmedical.com/content.aspx?aid=1106709501
RD 2024/04/18
AB DefinitionsBipolar  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  the  amniotic  fluid  with  a  decrease  in  the  thoracic  space-occupying  lesion.Thoracocentesis/vesicocentesis/fetal  cyst  aspiration:  these  diagnostic/therapeutic  ultrasound-guided  techniques  are  similar  to  amniocentesis,  but  the  needle  is  inserted  into  the  fetus  and  the  fluid  ...