What is a Fetoscope?

The fetus is healthy and growing with normal fetal movement and normal fetal heart rate.

The fetal scope is an amnio- or endoscope, which is a very fine fiber optic endoscope. Fetal microscopy is a method of fetal microscopy through the abdominal wall and uterine wall to enter the amniotic cavity, directly observe the fetal surface, and perform simple prenatal diagnosis of the fetus.

Name: Fetal scope

category: Endoscope

Normal fetal scope

The fetus is healthy and growing with normal fetal movement and normal fetal heart rate.

Clinical significance of fetal scope

Abnormal results:
(1) Diagnosis of congenital fetal malformations with obvious changes in appearance by direct observation.
For example, cleft lip, palate, polydactyly malformation, limb and finger deformity syndrome, osteochondral dysplasia, open neural tube malformation, visceral eversion, umbilical bulge, abdominal wall fissure and visceral ejection, conjoined twins, multiple limbs, large Hemangiomas, malformations of the external genitalia, etc. These diseases can be diagnosed directly with a fetal microscope.
(2) Congenital diseases diagnosed by fetal biopsy.
Fetal skin biopsy is mainly used to diagnose severe genetic skin diseases, such as bullous skin dissociation, ichthyosis, scaly scaly or scaly scaly.
For patients with fetal liver disease or diseases related to fetal liver enzyme metabolism, perform a fetal liver tissue biopsy.
Biopsy of fetal muscle tissue, such as fetal pseudohypertrophic muscular dystrophy, progressive spinal muscular atrophy, etc.
(3) Diseases diagnosed by taking fetal blood.
It can diagnose hemoglobin diseases such as thalassemia, sickle type anemia, hemophilia, chronic granulomatosis, galactosemia, mucopolysaccharidosis, maternal and child blood type incompatibility, genetic immunodeficiency disease, and fetal intrauterine virus infection.
(4) Intrauterine treatment of the fetus.
Intrauterine blood transfusion can be performed for severe fetal hemolytic anemia through fetal scope; for multiple pregnancy, one of the fetuses can be killed by cardiac puncture and air embolization of the malformed fetus; One child; Place drainage tube for hydrocephalus to reduce intracranial pressure and prevent further damage and shrinkage caused by compression of brain tissue; drainage tube can also be placed for urinary tract obstruction to reduce renal atrophy.
(5) Gene and cell therapy.
In recent years, gene therapy and cell therapy have developed rapidly. In the early stage of embryonic development, the fetal immune system has not been fully established, and fetal scopes can transport genes or cells into the fetus to achieve the purpose of treatment. At present, the method of gene therapy is still being studied. The only cells that can be introduced into the fetus are bone marrow cells, and research in this field is still ongoing.
People to be checked: those with abnormal fetal development and fetal development.

Fetal scope considerations

Unsuitable people: (1) Pregnant women with bleeding tendency, such as severe pregnancy-induced hypertension, pregnancy with thrombocytopenia.
(2) Pregnancy with abortion or premature birth.
(3) Suspected intrauterine infection, such as elevated white blood cells and so on.
(4) Those with severe pregnancy complications.
Contraindications before examination: (1) Ultrasound examination, size, determination of fetal position, disc and fetus. Understand the placenta position, the amount of amniotic fluid, estimate the fetus to choose the puncture point of the fetal scope, try to avoid the fetus
(2) Pregnant women empty the bladder and routinely prepare the abdomen for skin preparation.
(3) 10 minutes before the operation, sedatives can be given intramuscularly with 10 mg of diazepam to achieve the purpose of sedation and reduce fetal activity in pregnant women. May also be given intramuscular injection of 100mg.
Requirement during inspection: Actively cooperate with the doctor.

Fetal microscopy

(1) Pregnant women take a supine position and routinely sterilize and spread towels;
(2) At the selected puncture site, after local infiltration and anesthesia, the skin is cut 2-5 mm deep and subcutaneously. The incision should be perpendicular to the surface of the uterus.
(3) After the assistant fixes the uterus, use the trocar to puncture the amniotic cavity through the incision of the abdominal wall, and there will be a second feeling of falling through the abdominal wall and the uterine wall. It is estimated that when entering the amniotic cavity, the needle core is withdrawn and amniotic fluid flows out from the trocar, indicating that it has entered the amniotic cavity. If you want an amniotic fluid test, you can do it at this time and then insert the fetal scope.
(4) After turning on the cold light source, observe the appearance of the fetus under the guidance of B-ultrasound, such as fingers, face, genitals, etc. It is affected by the transparency of amniotic fluid during direct observation. When the cellular components of the amniotic fluid increase or the fetus is contaminated or bleeding, the observation effect may be affected.
(5) If fetal blood sampling is needed, you can insert a sampling needle to take blood when you see the umbilical cord during the observation process, and you can also take a large puncture blood from the placental surface.
(6) If fetal tissue biopsy is needed, first remove the fetal scope, put it into biopsy forceps, and take the specimen under the guidance of B-ultrasound.
(7) After the operation is completed, the fetal scope and the cannula are pulled out at the same time. Use B-ultrasound to observe whether there is active bleeding at the puncture site, whether the fetal heart rate and fetal activity are normal; at the same time, the blood pressure, heart rate, fetal heart rate, uterine contraction, and amniotic fluid leakage of the pregnant woman are dynamically observed. hour.