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Chapter-32 Fetal Surgery

BOOK TITLE: Operative Obstetrics and Gynecology

Author
1. Deka Deepika
ISBN
9788184485370
DOI
10.5005/jp/books/11088_32
Edition
1/e
Publishing Year
2009
Pages
11
Author Affiliations
1. All India Institute of Medical Sciences (AIIMS), New Delhi, India, All India Institute of Medical Sciences, New Delhi, All India Institute of Medical Sciences , New Delhi, All India Institute of Medical Sciences, New Delhi, India, Genetics and Fetal Medicine Committee (FOGSI)-(2007-2010), India, Perinatal Medicine Committee Association Obstetrics and Gynaecology of Delhi (AOGD), India, All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India; Genetics and Fetal Medicine Committee (FOGSI)-(2007-2010), India, Perinatal Medicine Committee Association Obstetrics and Gynaecology of Delhi (AOGD), India, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, AIIMS New Delhi-110029, New Delhi, India, AIIMS, New Delhi, India, AIIMS, New Delhi, Obstetrics and Gynecology AIIMS, New Delhi, All India Institute of Medical Science, New Delhi, All India Instiute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences, Ansari Nagar,
Chapter keywords
complications, gangrenous ovaries, hysterotomy, chromosomal anomalies, pregnancies, fetal trachea, hydropic fetuses, surgical resection, perinatal death, mediastinal compression

Abstract

This chapter discusses various aspects of fetal surgery in detail. Evolution of fetal surgery, principles of fetal surgery, ureteropelvic junction (UPJ) obstruction, ureterovesical junction (uvj) obstruction, urethral obstruction, sacrococcygeal teratoma (SCT), and congenital diaphragmatic hernia (CDH), are some topics discussed in detail. For fetuses less than 32 weeks with oligohydramnios, evaluation of underlying renal function is done by sequential ultrasound guided vesicocentesis in which the fetal bladder is completely drained at 48-72 hr intervals on a minimum of two to three occasions. Fetal pleural effusions may lead to lung compression and hypoplasia, and could be due to chylothorax. Fetal SCT necessitates frequent monitoring to ensure the detection of fetal/maternal complications by ultrasound and Doppler ultrasound. Fetal/neonatal ovarian cyst may lead to complications such as torsion, and is an indication for surgical intervention.

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