First trimester transabdominal embryo fetoscopy.
The aim of this study was the visualization of the embryo and blood sampling through transabdominal embryoscopy during the first 12 week of pregnancy. Twenty women attending Alexandra Maternity Hospital, Athens for pregnancy termination were invited to participate in this study. Informed consent was obtained before participation. The gestational age ranged between 9 and 12 weeks from LMP. We used a Karl Storz semirigid fiberoptic endoscope 20 cm in length, with a diameter of 1 mm and an angle of view of 70 degrees. Under local anesthesia the endoscope was introduced transabdominally into the amniotic sac, using continuous ultrasound guidance. Complete examination of the embryo including head, face, limbs ventral and dorsal walls, genitalia, placenta, umbilical cord and yolk sac were performed. A 0,6 mm diameter puncture needle was inserted into the blood vessels of the chorionic plate or umbilical cord through the side arm of the canulla to obtain a small amount of blood. The complete anatomical survey was possible in all cases (100%). Access to the embryonic circulation was attempted in 14 cases. A small quantity of blood was obtained in 10 cases (71,4%). The average length of the procedure was 15 min. No maternal complications were recorded. D & C were performed 24 hours after the embryoscopy. Embryoscopy represent a diagnostic tool to confirm a diagnosis suspected through noninvasive means. Gaining access to the embryonic circulation when embryos are immunologically naïve will allow perhaps gene or cell therapy. Finally embryoscopy may be helpful to study the biology of embryonic development.
Miliou-Paouleskou
D
D
1st Dept of Obstetrics and Gynecology, Division of Fetal Maternal Medicine, University of Athens, Alexandra Maternity Hospital, Athens, Greece.
Antsaklis
A
A
Papantoniou
N
N
Koutra
P
P
Daskalakis
G
G
D004622:Embryo, Mammalian / Q000098:blood supply; D005260:Female; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First