Ms. Xiong, who was diagnosed as "Twin Transfusion Syndrome" at the 0/7th week of pregnancy/KLOC, successfully gave birth to a pair of healthy twins on June 28th after undergoing laser coagulation of the placental vascular anastomosis branch under the fetal microscope in the Provincial Maternal and Child Health Hospital. This is the first case in our province in which a 36-week-old twin live baby was obtained after fetal mirror surgery, marking a breakthrough in fetal medicine in our province.
Fetal mirror is not a mirror, but like gastroscope and enteroscope, it is a medical examination through endoscopic surgery.
A fiber optic endoscope with a diameter of 1-3mm is like a small "eye". It drills into the trocar, passes through a long "tunnel", passes through the abdominal wall and inner wall of pregnant women, enters the amniotic cavity, and visits the fetus in the small world where the fetus lives.
Expectant mothers are always curious and anxious about the fetus in their bellies. Fetal mirror, like well-known B-ultrasound and amniocentesis, has the function of prenatal diagnosis. If B-ultrasound is like "calling", we can know the baby's situation through ultrasound; Amniocentesis is the collection of "express delivery", through the extraction of amniotic fluid samples of pregnant women, to obtain information on fetal health and development; Then the fetal mirror is a formal "face to face", and the body surface, umbilical cord and placenta of the fetus can be directly observed during the operation. ...
This is an excellent opportunity for doctors to observe the fetus, and can diagnose body surface abnormalities before the fetus is born, such as fetal albinism, cleft lip and palate, polydactyly and so on. Fetal tissue can also be taken out for biopsy. For example, taking fetal skin for biopsy can find hereditary diseases such as ichthyosis; Muscle biopsy can find fetal pseudohypertrophic muscular dystrophy.
Fetal mirror not only has diagnostic function, but also can be used for intrauterine treatment.
At present, the most widely used treatment method in clinic is fetal mirror twin transfusion syndrome. Usually, identical twins use placenta and share the nutrition provided by their mothers equally. But sometimes because there are blood vessels between fetuses, they will compete for nutrition, and the blood of the fetus may be too much, while the blood of the donor fetus is too little. This is twin transfusion syndrome. Without timely intervention, the mortality rate is as high as 80- 100%.
How can we intervene and treat more accurately? Fetal mirror provides a new window for perinatal medicine and intrauterine treatment. Laser coagulation of vascular anastomosis branches under fetal microscope can coagulate the blood vessels connecting two fetuses and treat complications such as twin transfusion syndrome and polycythemia sequence syndrome.
It is worth noting that the application of fetal mirror should be determined according to the purpose of examination, amniotic fluid volume of pregnant women, fetal size and umbilical cord thickness. Secondly, as a minimally invasive operation, fetal mirror still has certain risks, such as bleeding, infection, abortion, premature rupture of membranes and so on. Therefore, whether pregnant women need surgery depends on the professional analysis of doctors in regular medical institutions.
(Scientific Guidance: Jia, Director of the Second Division of Hunan Maternal and Child Health Hospital)
[Editor: Mo Youzheng]
[Source: Hunan Daily New Hunan Client]