Successful tracheal occlusion using ultrathin fetoscopic equipment combined with real-time three-dimensional ultrasound.
OBJECTIVE
The most common complication of intrauterine tracheal balloon occlusion is the preterm premature rupture of membranes (PPROM) which increases the rate of neonatal morbidity and mortality. Ultrathin fetoscopy may be a method of reducing the risk of PPROM.


METHODS
The operation was performed at the 27th week of gestation after sedation and relaxation of a fetus with bilateral congenital diaphragmatic hernia and with the liver lifted upwards into the thorax. An ultrathin sheath with a 1.2-mm fetoscope was used under real-time 3-D ultrasound guidance. The patient delivered in the 38th week of gestation and did not display PPROM after surgery until delivery.


CONCLUSIONS
Fetal tracheal occlusion using ultrathin fetoscopic equipment in combination with real-time 3-D ultrasound may reduce the risk of PPROM.
Tchirikov
M
M
Department of Obstetrics and Fetal Medicine, Johannes Gutenberg University Medical Center Mainz, Mainz, Germany. tchirikov@uni-mainz.de
D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000517:prevention & control; D020669:Fetoscopes; D005332:Fetoscopy / Q000379:methods*; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology; D016343:Monitoring, Intraoperative; D011247:Pregnancy; D014132:Trachea / Q000000981:diagnostic imaging / Q000601:surgery*; D016216:Ultrasonography, Prenatal