Prenatal regenerative fetoscopic interventions for congenital anomalies

BMJ. 2020 Jul 1:370:m1624. doi: 10.1136/bmj.m1624.

Abstract

Fetal intervention has progressed in the past two decades from experimental proof-of-concept to practice-adopted, life saving interventions in human fetuses with congenital anomalies. This progress is informed by advances in innovative research, prenatal diagnosis, and fetal surgical techniques. Invasive open hysterotomy, associated with notable maternal-fetal risks, is steadily replaced by less invasive fetoscopic alternatives. A better understanding of the natural history and pathophysiology of congenital diseases has advanced the prenatal regenerative paradigm. By altering the natural course of disease through regrowth or redevelopment of malformed fetal organs, prenatal regenerative medicine has transformed maternal-fetal care. This review discusses the uses of regenerative medicine in the prenatal diagnosis and management of three congenital diseases: congenital diaphragmatic hernia, lower urinary tract obstruction, and spina bifida.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Fetal Diseases / surgery*
  • Fetoscopy / history*
  • Fetoscopy / methods
  • Hernias, Diaphragmatic, Congenital* / embryology
  • Hernias, Diaphragmatic, Congenital* / surgery
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Patient Selection
  • Prenatal Diagnosis
  • Spinal Dysraphism* / embryology
  • Spinal Dysraphism* / surgery
  • Urethral Stricture / embryology
  • Urethral Stricture / surgery*