Fetoscopy is a technology that allows direct visualization of the fetus during pregnancy through small diameter endoscopes. Additionally, more instruments can be used to perform operations within the uterus. Obviously, fetoscopy is not to be used in most pregnancies, but a selected number of pregnancy complications affecting the fetus may benefit of the use of this technique. Fetoscopy can essentially be used for diagnostic or therapeutic purposes.
Diagnostic fetoscopy usually has a role in very early stages of pregnancy, when the fetus is still very small and the resolution of ultrasound does not allow for a precise visualization. At this time it may be called embryoscopy, or embryofetoscopy. Fetoscopy permits a high-resolution visualization of the embryo or fetus, and although in a very limited number of cases, it finds indications:
- very early in pregnancy (9-10 weeks) in families affected by recurrent genetic conditions in pregnancy diagnosable by characteristic external features
- to confirm or rule out suspected fetal anomalies in the early ultrasound examination (10-14 weeks)
In these cases, fetoscopy may allow a
rapid diagnosis reducing considerably the impact of prolonging pregnancy until ultrasound
is capable to ensure the diagnosis. In later stages of pregnancy, the resolution of
ultrasound confines the usefulness of fetoscopy to exceptional cases.
Operative fetoscopy is the use of fetoscopy to perform operations on the
fetus, the cord, placenta or membranes. In some very rare conditions, an operation on the
fetus may save its life or prevent irreversible significant sequelae. Fetoscopic
procedures allow to operate on the fetus through minimally invasive access. One or more
small diameter instruments can be introduced in the uterus and several procedures can be
performed. At present, most indications for operative fetoscopy are still investigative,
but a few have already gained acceptance, and a considerable number of fetuses have
benefited from the application of this technique.
