Time-related cotyledonary effects of laser coagulation of superficial chorionic vessels in an ovine model.

Endoscopic Nd:YAG laser coagulation of superficial chorionic plate vessels has been suggested as a 'causal' therapy for severe twin-to-twin transfusion syndrome (TTS), as it is believed to arrest flow over vascular anastomoses. The therapy remains debated, partly because it is questioned whether coagulation of superficial chorionic vessels can arrest blood flow over deeply located anastomoses. The latter are believed to be responsible for the majority of cases of severe TTs.

Tracheoscopic endoluminal plugging using an inflatable device in the fetal lamb model.

Objective: Intra-uterine tracheal occlusion has been proposed to reverse pulmonary hypoplasia, an important prognostic factor in congenital diaphragmatic hernia. We aimed to evaluate the feasibility and pulmonary effects of tracheoscopic tracheal obstruction with a detachable balloon.

Study Design: Fourteen mid-trimester fetuses out of 24 in 13 ewes underwent tracheoscopic balloon obstruction.

Experience with fetoscopic cord ligation.

Objective: In the case of a monochorionic multiple pregnancy with one non-viable fetus who compromises its co-twin, fetoscopic cord ligation may be performed. We describe our fetoscopic cord ligation technique and discuss the efficacy of cord ligation for salvaging the co-twin, based on available data.

Study Design: Descriptive case series of four cases and review of the cases published up to 1996.

Alternative technique for Nd: YAG laser coagulation in twin-to-twin transfusion syndrome with anterior placenta.

Nd: YAG laser coagulation is used to treat severe twin-to-twin transfusion syndrome (TTS). Success of the technique depends on visualization of the placenta, the fetal membranes and the targeted vessels, as well as obtaining an optimal inclination angle for laser coagulation. In the rare case of an extensive anterior placenta, it may be difficult to achieve these conditions using the percutaneous approach.

Fetal membrane closure techniques after hysteroamniotomy in the midgestational rabbit model.

Objective: We studied closure techniques for amniotic access in midgestational rabbits.

Study Design: Twenty-eight rabbits with a total of 313 amniotic sacs were used for this study. In each animal a 1 cm hysteroamniotomy was made in two amniotic sacs at 22 days' gestation (term = 32).