FETOSCOPY: All there is to know about Fetoscopy

Fetoscopy is a procedure that is carried out on pregnant women with the help of a fetoscope. A fetoscope is a thin and flexible medical apparatus. It carries out an endoscopic pregnancy test. The fetoscope is inserted into the uterus through an incision made in the stomach. An ultra sound is required when carrying out a fetoscopy. It ensures that the doctor can see where the incision is being carried out to avoid harming the baby and also how the fetoscope is moving in the womb. Fetoscopy is used to judge progress of the pregnancy or treat any abnormalities. The Amniocentesis procedure is another procedure that offers information during the prenatal period of the status of the fetus.

A fetoscopy is carried out in the when the placenta is developed enough to allow a diagnosis of potential abnormalities in the baby's growth. This necessarily dictates that a fetoscopy should be carried out in the 18th week.

Some potential reasons that necessitate the use of a fetoscopy are:

  1. Evaluate possible problems in fetal growth like spina bifida. There are also other fetal growth disorders that require a fetoscopy-check such as
    • Where two fetuses (twins) end up sharing a placenta in the mother's womb. This is normally referred to as twin/twin transfusion syndrome (TTTS). This condition leads to the donor twin not having enough amounts of blood while the receiving twin ends up having a large volume of blood. There is a 70%-80% mortality rate among cases of twin/twin transfusion syndrome if there is no intervention.
    • Another case scenario that requires fetoscopy is congenital diaphagramatic hernia (CDH). This is characterized by the fetus having a diaphragm that is not properly developed. This has the probability of causing pulmonary hyperplasia where abdominal organs extend into the chest cavity.
    • An arcadiac twin also necessitates a fetoscopy. This is a situation where a fetus develops no heart especially in twins. It sometimes occurs in a monochrionic pregnancy. The mortality rate in arcadiac rate is somewhere between 50%-75% and about 1% where we have monochrionic pregnancies.
    • A fourth condition that will necessitate a fetoscopy is a urinary tract obstruction. This happens where the urethra does not develop normally or is blocked. A major result of this is pulmonary hypoplasia.
  2. Samples of blood from the umbilical cord are required. These will be used to test for abnormalities or diseases like anaemia (sickle cell) or hemophilia.
  3. For fetuses skin tissue samples. Inherited diseases can be tested from these samples.
baby during the fetoscopy

A fetoscopy is generally a very high risk procedure for both the mother and her baby. It should therefore only be carried out if there is an elevated probability of abnormality. Another reason may be that the family has a birth defect history that is strong.

How to Prepare for a Fetoscopy

It is normally advised that the mother does not drink or eat anything for a period of 8 hours before the scheduled time of the procedure. Sometimes the mother is given antibiotic drugs to reduce the chances that she might get an infection. There are also some legal requirements involved when you want a fetoscopy to be carried out. The mother is required to sign a consent form that shows she is fully aware of any that are involved in carrying out a fetoscopy.

The Procedure

  • The first thing that needs to be checked is the fetal heartbeat to determine the fetal heart rate. Some medication is administered to the mother to prevent the fetus from having a lot of fetal movement.
  • The mother is then required to lie facing upwards. The stomach is the raised slightly so that the mother's stomach muscles are allowed to relax.
  • After cleaning, an ultrasound is performed and an incision is made where the fetoscope is inserted through.
  • Samples are collected for later assessment and laboratory tests

Aftermath of a Fetoscopy

The incision that was made in the mother's stomach is stitched up and covered with a bandage. To ensure that the baby is alright and to check for satisfactory levels of the amniotic fluid, and ultra sound is performed. The very next day, the ultra sound procedure is repeated to check for the stated conditions.

Risks Associated with Fetoscopy

  • The rates of miscarriages associated with fetoscopy are up to 12% which is alarmingly a very high rate for a medical procedure.
  • There are reported cases of too much bleeding or amniotic fluid leakages as well as infections
  • Sometimes the mother and her baby's blood may mix up.
  • Early delivery due to premature membrane rapture
the fetoscopy procedure

Even after a successful fetoscopy has been carried out, several follow up checks are necessary. You should also consult a doctor if any of the following are experienced later on.

  1. Fever or chills
  2. Abdominal pain that may be moderate or severe, or cramping.
  3. Vaginal blood or fluid leakage or from where the incision was made.
  4. Dizziness.

In general, a fetoscopy is a very sensitive procedure that should only be carried out if it is absolutely necessary.

You might also like more information about the fetal doppler.