FETO
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FETO introduction
Fetal endoluminal tracheal occlusion (FETO) is a procedure performed during pregnancy to help with lung development in babies who have a condition where their lungs are not fully developed. This is done by inserting a balloon into the baby's trachea (windpipe) through a percutaneous sono-endoscopic approach, using techniques commonly seen in interventional radiology. The purpose of FETO is to temporarily block the baby's airway, which allows the lungs to retain fluid and grow, leading to better lung development. Following this, the occlusion can be reversed through various methods such as fetoscopy, transabdominal puncture, tracheoscopy, or by removing the balloon after the baby is born if necessary. Studies have shown that FETO and the subsequent removal of the balloon are generally safe procedures when performed by experienced medical professionals. It is crucial to have a highly skilled team involved in carrying out these interventions to ensure the best possible outcomes for both the mother and the baby.
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Fetoscopic Endotracheal Occlusion
Fetoscopic Endotracheal Occlusion (FETO) is a minimally invasive procedure aimed at improving postnatal lung function in fetuses with severe Congenital Diaphragmatic Hernia (CDH). CDH is a condition characterized by a hole in the fetal diaphragm muscle, leading to the displacement of abdominal organs into the chest cavity, which can compress the lungs and hinder fetal lung development. Key Points of Fetoscopic Endotracheal Occlusion (FETO): - FETO involves the temporary blocking of the fetal trachea using a balloon or plug, which helps to stimulate lung growth and development in utero. - By relieving the pressure on the lungs caused by the displaced abdominal organs, FETO aims to enhance lung function and improve the chances of survival for the affected fetus after birth. - The procedure is performed using a fetoscope, a minimally invasive endoscopic instrument, which allows doctors to access and perform the occlusion without the need for open surgery. - FETO is usually recommended for fetuses with severe CDH where lung growth is significantly compromised, with the goal of increasing lung size and function before delivery to optimize postnatal outcomes. - Following the procedure, close monitoring of the fetus and regular assessments are essential to evaluate lung growth and development, as well as to determine the appropriate timing for delivery. Overall, Fetoscopic Endotracheal Occlusion plays a crucial role in the management of severe CDH by promoting fetal lung development and improving postnatal respiratory function for better outcomes.
Purpose of FETO procedure
The purpose of the FETO (Fetoscopic Endoluminal Tracheal Occlusion) procedure is to help improve outcomes for babies diagnosed with congenital diaphragmatic hernia (CDH), a life-threatening condition affecting a small percentage of live born babies. The procedure aims to address the diaphragmatic defect that allows abdominal organs to herniate into the thorax, which in turn prevents normal lung development. Specifically, the FETO procedure focuses on the following objectives: - Correction of Diaphragmatic Defect: By using fetoscopic techniques, the procedure aims to occlude the trachea, which may help promote lung growth and recovery by temporarily blocking the herniated abdominal organs from impacting lung development. - Enhanced Lung Development: By limiting the interference of herniated organs in the thoracic cavity, the FETO procedure seeks to create a more conducive environment for lung growth, ultimately improving respiratory function in the affected baby. - Reduction of Associated Anomalies: The procedure serves the crucial purpose of potentially reducing the impact of associated anomalies, which are common in CDH cases and can have independent effects on the baby's survival and overall health. Imaging and genetic testing are utilized to identify and address these anomalies as part of the FETO procedure. Overall, the FETO procedure is designed to provide a targeted intervention to address the specific challenges posed by CDH, aiming to optimize lung development, reduce associated risks, and improve the chances of a positive outcome for the baby.
Candidates for FETO
Candidates for FETO (Fetoscopic Endoluminal Tracheal Occlusion) are typically fetuses diagnosed with severe Congenital Diaphragmatic Hernia (CDH) cases, especially when their fetal lungs are extremely small. Here are the key considerations for identifying potential candidates for FETO: - The mother should be examined early after diagnosis, ideally between 22 and 26 weeks gestation. - Evaluation for eligibility typically involves the following assessments: - Ultrasound: To assess the severity of the CDH and the size of the fetal lungs. - Fetal Echocardiogram: To evaluate the heart function and ensure the fetus is stable for the procedure. - Amniocentesis: To gather additional information and confirm the suitability of the fetus for FETO. It's important for healthcare providers to carefully review these criteria to determine the appropriateness of FETO for each individual case of severe CDH.
Procedure for FETO
Fetoscopic endotracheal occlusion (FETO) is a specialized procedure typically performed between 26 and 28 weeks of gestation. The intricate process aims to improve lung development in fetuses with specific conditions, such as diaphragmatic hernia. The detailed steps involved in the FETO procedure include: - Sedation: The mother is sedated to ensure comfort and relaxation during the procedure. - Incision: A small incision is made in the mother's abdomen and uterus to access the fetus. - Insertion: A tube and endoscope are carefully guided into the fetus's trachea. - Balloon Placement: A balloon is delicately positioned to block the airway, encouraging lung growth and maturation. - Monitoring: Throughout the procedure, medical professionals closely monitor the fetus's condition and response to the intervention. - Balloon Removal: The balloon is typically removed before the baby's birth to facilitate a smooth delivery process. By following these meticulous steps, healthcare providers can enhance the respiratory outcomes for fetuses undergoing FETO, thereby improving their overall prognosis.
Recovery after FETO
After undergoing FETO (Fetoscopic Endoluminal Tracheal Occlusion), both the mother and baby require careful monitoring to ensure optimal recovery and well-being. Here is a detailed outline of the recovery process: - The mother and baby will be closely monitored post-FETO through weekly ultrasounds. These sessions are essential for tracking the progress and ensuring the health of both individuals. - It is crucial for the mother to remain within a 30-minute proximity of the fetal center while the balloon used in the procedure is in place. This close proximity allows for immediate access to specialized medical care if needed. - Around the 34th week of pregnancy, a second procedure is typically performed to either remove or deflate the balloon that was placed during the FETO procedure. This step is significant in the overall recovery process and is vital for both the mother and baby's well-being.
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Frequently asked questions
What is the purpose of FETO procedure?
The purpose of the FETO procedure is to help improve outcomes for babies diagnosed with congenital diaphragmatic hernia (CDH) by promoting lung growth and recovery through tracheal occlusion.
Who are the candidates for FETO?
Candidates for FETO are typically fetuses diagnosed with severe Congenital Diaphragmatic Hernia (CDH) cases, especially when their fetal lungs are extremely small.
What are the key points about Fetal Tracheal Occlusion?
Fetal Tracheal Occlusion is a prenatal intervention designed to improve lung development in fetuses with congenital diaphragmatic hernia by placing a balloon or plug in the fetal trachea.
What are the complications of FETO?
Complications of FETO may include adverse reactions to anesthesia, infection, bleeding, risks associated with balloon placement, preterm labor, and respiratory complications in the baby.
When should FETO be considered?
FETO should be considered when a fetus is diagnosed with Congenital Diaphragmatic Hernia (CDH) and when there is a risk of underdeveloped lungs causing breathing difficulties at birth.
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