Intrauterine interventions
Intrauterine interventions in nagpur are medical procedures conducted directly on the fetus or placenta within the womb. This intervention is applied in assessing or treating any condition found to affect the fetus in such a way that it stands a better chance of delivering healthy and alive.
Intrauterine interventions have totally transformed the branch of fetal medicine, where doctors can:
- Treat congenital defects and anomalies.
- Complications like twin-to-twin transfusion syndrome.
- Address issues of fetal growth restrictions.
- Perform fetal blood transfusions.
- It can perform fetal surgeries.
Intrauterine interventions refer to direct application of medical procedures to the fetus or the placenta in utero for diagnosing or treating varied conditions. Common intrauterine interventions include the following:
1. Fetal blood transfusion: this is the delivery of blood to the fetus to treat anemia or disorders related to blood.
2. Fetal surgery: surgical intervention on the fetus such as correcting congenital defects, removing tumors, and more.
3. Fetal shunt placement: Placement of a shunt in the body to drain extra fluid from the brain or anywhere in the body.
4. Radiofrequency ablation (RFA): Treatment by application of heat for conditions such as twin-to-twin transfusion syndrome, etc.
5. Laser therapy: The treatment of laser energy for conditions like twin-to-twin transfusion syndrome or placenta previa, etc.
6. Amniofusion: Fluid is injected into the amniotic sac for management of oligohydramnios or low amniotic fluid.
7. Fetal endoscopic procedures : Visualization and treatment of many conditions such as congenital diaphragmatic hernia through a small camera known as the endoscope.
8. Intrauterine gene therapy: Introduce genes in the fetus for the treatment of genetic disorders.
The interventions are done by a multidisciplinary team of specialists: mothers with specialization in maternal-fetal medicine, pediatric surgeons, and neonatologists. The procedures can be lifesaving but always hold some risk.
What Is a Intrauterine interventions ?
There exist several forms of intrauterine interventions. These involve;
1. Fetal surgery: Procedures performed on the fetus to treat birth defects and remove tumors.
2. Fetal blood transfusion: This is the transfer of blood into the fetus to treat anemia or other blood-related disorders.
3. Fetal shunt placement: This is the process of placing a shunt to drain extra fluid within the brain or other areas in the body.
4. Radiofrequency ablation (RFA) :Heat is used to treat conditions such as twin-to-twin transfusion syndrome.
5. Laser therapy: Applying laser beams to treat conditions such as twin-to-twin transfusion syndrome or placenta previa.
6. Amniofusion: Administering fluid to the amniotic sac with a view to managing oligohydramnios.
7. Fetal endoscopic procedures: Such procedures make use of an endoscope to visualize and treat for instance congenital diaphragmatic hernia.
8. Intrauterine gene therapy: Introducing genes in the fetus to treat genetic disorders.
Diseases and conditions:
1. Structural Abnormalities- Congenital Heart Disease. Neural Tube Defects, etc.
2. Twin-to-Twin Transfusion Syndrome: In this condition, twins share unequal amounts of blood.
3. Placenta Previa: In this condition, the placenta covers part of the cervix.
4. Oligohydramnios: Amniotic fluid levels are low.
5. Fetal Anemia: Red blood cell count in the fetus is lower.
6. Congenital Diaphragmatic Hernia: The hole in a diaphragm.
7. Genetic Disorders: Such as sickle cell disease. Sometimes genetic conditions are more dangerous.
Benefits and Risks:
Benefits:
– Potentia for managing potentially life-threatening conditions
– Can improve fetal outcome
– Can reduce the risk of complications at time of delivery
Risks:
– Preterm birth
– Infection
– Bleeding
– Fetal distress
– Maternal complications
Multidisciplinary Team:
1. Specialists in Maternal-Fetal Medicine
2. Pediatric Surgeons
3. Neonatologists
4. Obstetricians
5. Geneticists
Intrauterine intervention requires good considerations and close monitoring on the part of a multidisciplinary team to ensure that the best possible outcomes are achieved both for the mother and for the fetus.
Key Types of Intrauterine Interventions:
- Intrauterine Insemination (IUI):
- Purpose: A fertility treatment where sperm is inserted directly into the uterus to facilitate fertilization.
- Use: Typically used for couples facing male factor infertility, unexplained infertility, or issues related to cervical mucus.
- Intrauterine Device (IUD) Insertion:
- Purpose: A long-term contraceptive device placed inside the uterus.
- Use: Prevents pregnancy either by releasing hormones or by using a copper-based device to create an inhospitable environment for sperm.
- Hysteroscopy:
- Purpose: A procedure where a small camera (hysteroscope) is inserted into the uterus to diagnose or treat uterine abnormalities.
- Use: Identifies issues like fibroids, polyps, adhesions, or septums; it can also be used for treatment, such as removing polyps or fibroids.
- Endometrial Ablation:
- Purpose: A procedure to remove and destroy the endometrial lining of the uterus.
- Use: Treats heavy menstrual bleeding in women who do not wish to become pregnant in the future.
- Amniocentesis:
- Purpose: A diagnostic procedure in which amniotic fluid is extracted from the uterus to test for genetic abnormalities or fetal infections.
- Use: Commonly performed between 15 and 20 weeks of pregnancy to detect conditions like Down syndrome.
- Chorionic Villus Sampling (CVS):
- Purpose: A prenatal test where a sample of placental tissue is taken to test for genetic abnormalities.
- Use: Provides early diagnosis of chromosomal disorders, such as trisomies, during the first trimester of pregnancy.
- Intrauterine Fetal Transfusion:
- Purpose: A procedure where blood is transfused directly to a fetus to treat fetal anemia.
- Use: Often used in cases of Rh incompatibility or other conditions that lead to fetal blood disorders.
- Fetal Surgery (Intrauterine Fetal Surgery):
- Purpose: A surgical procedure performed on the fetus within the uterus to correct life-threatening congenital abnormalities.
- Use: Treats conditions such as spina bifida, diaphragmatic hernia, or twin-to-twin transfusion syndrome.
- Uterine Artery Embolization (UAE):
- Purpose: A minimally invasive procedure to block blood flow to fibroids within the uterus.
- Use: Used to shrink fibroids and alleviate symptoms such as heavy bleeding and pain without requiring a hysterectomy.
Common Intrauterine Interventions:
1. Intrauterine Insemination (IUI)
- Description: A fertility treatment where sperm is inserted directly into the uterus during ovulation to increase the chances of fertilization.
- Use: Addresses infertility issues such as low sperm count, cervical mucus problems, or unexplained infertility.
- Procedure: A catheter is used to place prepared sperm into the uterus.
2. Intrauterine Device (IUD) Insertion
- Description: A small, T-shaped contraceptive device placed inside the uterus to the prevent pregnancy. There are two types: hormonal and copper.
- Use: Provides long-term birth control, effective for 3-10 years depending on the type.
- Procedure: Inserted through the cervix into the uterus by a healthcare provider.
3. Hysteroscopy
- Description: A minimally invasive procedure that uses a thin, lighted scope (hysteroscope) inserted through the cervix to view the inside of the uterus.
- Use: Diagnoses and treats uterine abnormalities such as fibroids, polyps, adhesions (Asherman’s syndrome), or septums.
- Procedure: Can be performed for diagnostic purposes (diagnostic hysteroscopy) or to carry out surgical interventions (operative hysteroscopy).
4. Endometrial Ablation
- Description: A procedure that destroys the lining of the uterus (endometrium) to the reduce and stop abnormal uterine bleeding.
- Use: Often used in women with heavy menstrual bleeding who do not plan to have children in the future.
- Procedure: Various methods can be used to ablate the endometrium, including heat, cold, or radiofrequency energy.
5. Amniocentesis
- Description: A prenatal diagnostic test where a small amount of amniotic fluid is extracted from the uterus for testing.
- Use: Detects genetic disorders, chromosomal abnormalities (e.g., Down syndrome), and fetal infections. Usually performed between 15-20 weeks of the pregnancy.
- Procedure: A needle is inserted through the abdomen into a uterus to the withdraw fluid.
6. Chorionic Villus Sampling (CVS)
- Description: A prenatal test where a small sample of cells from the placenta (chorionic villi) is taken to test for genetic conditions.
- Use: Detects chromosomal abnormalities and genetic disorders early in pregnancy, typically between 10-13 weeks.
- Procedure: A catheter or needle is used to collect the tissue sample via the cervix or abdomen.
7. Intrauterine Fetal Transfusion
- Description: A procedure where blood is transfused directly to a fetus, typically through the umbilical cord.
- Use: Treats fetal anemia, especially due to Rh incompatibility or other blood disorders.
- Procedure: Blood is the transfused via a needle inserted into a uterus.
8. Intrauterine Fetal Surgery
- Description: A specialized surgery performed on the fetus while still in the womb to correct certain congenital conditions.
- Use: Treats conditions such as spina bifida, congenital diaphragmatic hernia, or twin-to-twin transfusion syndrome.
- Procedure: A highly specialized team performs the surgery through the uterus, either using fetoscopy or open fetal surgery.
9. Uterine Artery Embolization (UAE)
- Description: A minimally invasive procedure used to treat uterine fibroids by blocking the blood supply to the fibroids, causing them to shrink.
- Use: An alternative to hysterectomy for women with fibroids who wish to preserve their uterus.
- Procedure: Tiny particles are injected into the arteries supplying the fibroids to block blood flow.
10. Saline Infusion Sonohysterography (SIS)
- Description: A diagnostic test where saline is injected into the uterus during an ultrasound to get a clearer view of the uterine lining.
- Use: Detects abnormalities like polyps, fibroids, or uterine malformations.
- Procedure: A catheter is used to inject saline into the uterus, followed by an ultrasound to capture images.
Benefits of Intrauterine Interventions:
- Minimally Invasive: Many intrauterine interventions are less invasive compared to traditional surgery, leading to quicker recovery times.
- Preserves Fertility: Procedures like hysteroscopy and endometrial ablation can treat conditions without the need for more drastic interventions like hysterectomy.
- Prenatal Diagnostics: Tests such as amniocentesis and CVS provide critical information about fetal health, allowing parents to make informed decisions.
What procedures Intrauterine interventions ?
Intrauterine interventions are procedures conducted on a fetus and placenta during pregnancy. Procedures include but are not a limited to:
1. Fetal Surgery: The surgical procedure to repair congenital defects or removal of tumors.
2. Fetal Blood Transfusion: Transfusion of blood to the fetus to treat anemia or other blood-related disorders.
3. Fetal Shunt Placement: Putting a shunt in position in excess fluid drainage of the brain or other body parts.
4. Radiofrequency Ablation (RFA): The application of heat in the treatment of conditions such as twin-to-twin transfusion syndrome.
5. Laser Therapy: An injection of laser energy in the treatment of twin-to-twin transfusion syndrome, for example, or in placenta previa.
6. Amniofusion: Injecting fluid into the amniotic sac in the management of cases of oligohydramnios, low amniotic fluid.
7. Fetal Endoscopic Procedures: The use of a miniature camera known as an endoscope that allows for visualization and treatment of areas of the fetus, such as congenitally herniated diaphragm.
8. Intrauterine Gene Therapy: Direct gene introduction into the fetus to treat genetic diseases.
9. Fetal Cardiac Interventions: Procedure in treatment, such as balloon valvuloplasty or stenting, that deals with congenital heart defects.
10. Fetal Neurointerventions: Following the treatment of conditions like hydrocephalus or spinal bifida.
These procedures are mainly applied to improve fetal outcomes and control complications during pregnancy.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.