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Articolul urmator |
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Ultima descărcare din IBN: 2020-04-09 11:17 |
SM ISO690:2012 NEMESCU, Dragoş. Intervenţii fetale – experienţa centrului de medicină fetală. In: Buletin de Perinatologie, 2014, nr. 2(62), p. 60. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 2(62) / 2014 / ISSN 1810-5289 | ||||||
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Pag. 60-60 | ||||||
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The development of the prenatal diagnosis improved our capacity to diagnose fetal anomalies and other problems, before birth. Therefore, the fetus has become more and more an independent subject of investigation and treatment. Fetal surgical interventions are the top of surgical innovation. They are performed for diagnosis purposes: chorionic villus biopsy, amniocentesis, cordocentesis, but also for treatment. Intrauterine fetal interventions have been developed for various severe fetal anomalies in order to increase the chance of survival and / or improve the postnatal prognosis: Laser coagulation (twin-twin transfusion syndrome), bladder or thoracic shunt, draining of cystic structures, endotracheal balloon (diaphragmatic hernia). Embryo-reduction is a particular form of intrauterine intervention addressing to high-order multiple pregnancies. We present aspects of fetal interventions made during 2010-2014 period. Data were obtained from Astraia database (over 3500 patients). We performed 56 chorionic villous biopsies, 214 amniocentesis, 2 cordocentesis and 6 selective embryo-reductions (over 11 gestational weeks). Two thoraco-amniotic shunts were placed; one fetal bladder shunt and we performed a coagulation of umbilical cord (TRAP syndrome). We performed also 17 intrauterine transfusions, on 5 patients with isoimmunisation. At the moment of the first fetal transfusion, the gestational ages were between 21-32 weeks, fetal haemoglobin was 3.7-8.5 g/dl and in two cases the fetuses presented hydrops. Intrauterine fetal treatments are extremely effective if they comply with the indication and also they enables continuation of pregnancy to gestational age at which risks of prematurity are greatly reduced. |
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Cuvinte-cheie chorionic villus biopsy, intrauterine laser, fetal shunt, fetal transfusion |
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