Advances in fetal therapy

Authors

  • R Katie Morris MRCOG,

    Medical Research Council RCOG Clinical Research Training Fellow
    1. School of Clinical and Experimental Medicine, University of Birmingham, Birmingham Women's Hospital, Metchley Park Road, Edgbaston, Birmingham B15 2TG, UK
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  • Ben C Chan BSc MD MRCOG,

    Fetal Medicine Subspecialist Trainee
    1. Fetal Medicine Centre, Birmingham Women's NHS Foundation Trust, Edgbaston, Birmingham B15 2TG, UK
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  • Mark D Kilby MD FRCOG

    Dame Hilda Lloyd Professor of Maternal and Fetal Medicine, Corresponding author
    1. Fetal Medicine Centre, Birmingham Women's NHS Foundation Trust, Birmingham B15 2TG, UK
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Fetal Medicine Centre, Birmingham Women's NHS Foundation Trust, Birmingham B15 2TG, UK Email: m.d.kilby@bham.ac.uk

Abstract

Key content

  • Fetal medicine is a rapidly developing subspecialty.
  • The mainstay of treatment for fetal alloimmune thrombocytopenia remains maternal immunoglobulin therapy.
  • Stem cell transplantation and gene therapy have advanced over the last decade but must still be considered experimental.
  • Laser coagulation is the best treatment for all stages of twin-to-twin transfusion syndrome presenting before 26 weeks of gestation.
  • Fetoscopic endoluminal tracheal occlusion appears to improve prognosis in severe congenital diaphragmatic hernia.

Learning objectives

  • To gain an overview of the recent developments in fetal therapy.
  • To understand the benefits and risks of different methods of fetal therapy.
  • To appreciate the importance of high-quality research in fetal medicine.

Ethical issues

  • With the option of fetal therapy, the value and implications of prenatal diagnosis have to be reviewed.
  • The acceptability of fetal therapy to parents and to society should be investigated.
  • The consideration of the mother and fetus as individual people presents an inherent difficulty in implementing randomised controlled trials in fetal medicine.

Please cite this article as: Morris RK, Chan BC, Kilby MD. Advances in fetal therapy. The Obstetrician & Gynaecologist 2010;12:94–102.

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