| Abstract [eng] |
This literature review will describe four common and relevant birth defects. Their pathogenetic mechanism, diagnosis and most importantly also relevant treatment options will be discussed. Spina bifida, twin-to-twin transfusion syndrome, congenital diaphragmatic hernia and lower urinary tract obstruction are all currently treatable by a prenatal approach in fetal surgery centres. Fetoscopic closure of the defect in spina bifida, laser coagulation of the placental anastomoses in twin-to-twin transfusion syndrome, fetal endoscopic tracheal occlusion in congenital diaphragmatic hernia or the placement of a vesicoamniotic shunt in lower urinary obstruction are all procedures that are nowadays performed in several fetal surgery centres in Europe. During the last decades, a prenatal approach to the management of these four birth defects has been established and replaced several other approaches, frequently also the termination of the pregnancy. This development from a postnatal management to a prenatal one offers new perspectives to not only the survival of many of those affected pregnancies, but also the improvement regarding the child’s quality of life later on. Therefore, practicing obstetricians, pediatricians, or perinatologists that encounter patients whose pregnancy might be complicated by one of the mentioned birth defects should be aware of the treatment options that exist and to which fetal surgery centres to potentially refer the expecting mother. |
