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Fetal Therapy: Scientific Basis and Critical Appraisal of Clinical Benefits

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Updated by a team of internationally renowned experts, this book gives a thorough overview of fetal pathophysiology and an evidence base for in utero: both medical (non-invasive) and surgical treatments. Many topics are expanded to cover recent advances, including: stem cell transplantation; tissue scaffolding; minimally invasive approaches to ‘open fetal surgery’; the etiology, prevention and treatment of preterm birth and PROM; the genetic etiologies of fetal disease; and gene therapy. In addition, there are in-depth discussions as to the role of open fetal myelomeningocele repair and several fetoscopic approaches to therapy. The international editors have added important new chapters on reducing stillbirth and prenatal counselling. This book is an invaluable reference guide to the latest fetal therapy options, and an essential, in-depth study book for maternal-fetal and neonatology specialists.

Provides essential skills and up-to-date, evidence-based knowledge on fetal therapy for professionals caring for women with high-risk pregnancies

Critical appraisal of available techniques is highlighted so that realistic management decisions can be made

A team of renowned, international authors ensures content is valuable to professionals worldwide

Table of contents :
Cover……Page 1
Fetal Therapy:

Scientific Basis and Critical Appraisal of Clinical Benefits……Page 5
Copyright
……Page 6
Dedication
……Page 7
Contents
……Page 9
Contributors……Page 12
Foreword……Page 19
1 The Rationale for Fetal Therapy……Page 21
2 A Fetal Origin of Adult Disease……Page 28
3 Human Embryology: Molecular Mechanisms of
Embryonic Disease……Page 40
4 Human Genetics and Fetal Disease: Assessment
of the Fetal Genome……Page 56
5 Interventions in Pregnancy to Reduce Risk of Stillbirth……Page 68
6 Fetal Therapy Choices: Uncertain and Emotional
Decisions and the Doctor’s Role in Parental
Decision-Making
……Page 81
7 The Ethics of Consent for Fetal Therapy
……Page 89
8 Open Fetal Surgery: Is There Still a Role?……Page 97
9 The Artificial Womb……Page 103
10 Management of Red Cell Alloimmunization……Page 111
11 Fetal and Neonatal Alloimmune Thrombocytopenia:
Clinical Disease and Management……Page 119
12 Structural Heart Disease: Embryology……Page 130
13 Structural Heart Disease: Genetic Influences……Page 143
14 Deciphering the Mechanisms of Developmental Heart
Disease: Research from Embryonic Knockout Mice……Page 153
15 In Utero Intervention for Cardiac Disease……Page 166
16 Fetal Cerebral Consequences of Structural Heart
Disease: Can These Be Ameliorated?……Page 177
17 Fetal Supraventricular Tachyarrhythmias:
Pharmacokinetics, Modes of Action, and Results
of Anti-Arrhythmic Drug Therapy……Page 186
18 Fetal Dysrhythmias: Diagnosis and Clinical
Management……Page 196
19 Manipulation of Amniotic Fluid Volume: Homeostasis
of Fluid Volumes in the Amniotic Cavity……Page 211
20 Oligohydramnios and Polyhydramnios: Therapeutic
Manipulation of Amniotic Fluid Volume……Page 220
21 Fetal Infections: Immune Response to Infections
during Fetal Life……Page 235
22 Fetal Infections: Clinical Management……Page 244
23 Fetal Growth Restriction: Placental Basis and
Implications for Clinical Practice……Page 268
24 Fetal Growth Restriction: Diagnosis and Management……Page 284
25 Screening and Intervention for Fetal
Growth Restriction……Page 299
26 Maternal and Fetal Therapy: Can We Optimize
Fetal Growth?……Page 307
27 The Pathogenesis of Preterm Birth: A Guide to
Potential Therapeutic Targets……Page 322
28 Clinical Interventions for the Prevention and
Management of Spontaneous Preterm Birth in
the Singleton Fetus……Page 331
29 Clinical Interventions to Prevent Preterm Birth
in Multiple Pregnancies……Page 345
30 Reducing Neurologic Morbidity from Preterm Birth
through Administering Therapy Prior to Delivery……Page 353
31 Twin-to-Twin Transfusion Syndrome: Placental
and Fetal Pathogenesis……Page 364
32 Twin-to-Twin Transfusion Syndrome: Treatment by
Fetoscopic Laser Coagulation of the Placental Vascular
Anastomoses on the Chorionic Plate……Page 373
33 Interventions for Early and Late Twin-Twin
Transfusion Syndrome……Page 383
34 Diagnosis and Treatment in Twin Anemia
Polycythemia Sequence……Page 387
35 Neurological and Long-Term Neurodevelopmental
Outcome after Fetal Therapy in Complicated
Monochorionic Twins……Page 393
36 The Diagnosis and Detection of Fetal Growth
Restriction in Monochorionic Twin Pregnancies……Page 404
37 Clinical Outcome and Management of Selective
Fetal Growth Restriction in Monochorionic Twins……Page 412
38 Twin Reversed Arterial Perfusion Sequence:
Pathophysiology and In Utero Treatment……Page 418
39 Fetal Reduction and Selective Termination……Page 424
40 Selective Termination of One Fetus in
Monochorionic Twin Pregnancies……Page 438
41 Lower Urinary Tract Obstruction: Pathophysiology,
Prenatal Assessment, and In Utero Intervention……Page 446
42 Fetal Pleural Effusions and Pulmonary Pathology:
Pathophysiology and Clinical Management……Page 458
43 Neural Tube Anomalies: An Update on the
Pathophysiology and Prevention……Page 469
44 Neural Tube Anomalies: Clinical Management
by Open Fetal Surgery……Page 476
45 Open Neural Tube Defect Repair: Development and
Refinement of a Fetoscopic Technique……Page 487
46 Fetal Tumors: Clinical Management……Page 500
47 Congenital Diaphragmatic Hernia: Pathophysiology
and Antenatal Assessment……Page 514
48 Congenital Diaphragmatic Hernia: In Utero
Treatment Today and Tomorrow……Page 523
49 Stem Cell Transplantation: Clinical Potential in
Treating Fetal Genetic Disease……Page 532
50 Strategies to Repair Defects in the Fetal Membrane……Page 540
51 Tissue Engineering and the Fetus……Page 552
52 Gene Therapy: Principles and Clinical Potential……Page 560
53 Fetal Therapy and Translational Studies: Global
Alignment, Coordination, and Collaboration in
Perinatal Research – the Global Obstetrics
Network (GONet) Initiative……Page 581
54 Congenital Anomaly Registers: The
European Experience……Page 590
55 A Challenge for Prenatal Diagnosis in Developing
Countries: Zika Virus as an Exemplar……Page 600
Index……Page 608

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