Biomaterial Database

In utero surgery - current state of the art: part I. 2010

Piotr Wójcicki, and Piotr Drozdowski

Department of Plastic Surgery, Wroclaw Medical University, Polanica-Zdroj, Poland. piotr_drozdowski@wp.pl

BACKGROUND Fetal surgery, also referred to as in utero, prenatal or intrauterine surgery, consists of treatment of congenital malformations during fetal period. The idea of treating malformations diagnosed in the course of intrauterine life dates back to 1963, when Lilly performed first blood transfusion in the fetus. Ever since then, it has been introduced as treatment option in series of lethal malformations. Efforts are being made to treat nonlethal malformations by means of fetal surgery. METHODS A comprehensive search of the literature using MEDLINE and PubMed between 1925 and February 2009 was performed. Search terms for MEDLINE and PubMed were: fetal surgery, foetal surgery, in utero surgery, prenatal surgery, and in utero treatment. In addition, information was obtained at Web sites of International Medicine and Surgery Society and the University of California Fetal Treatment Centre. RESULTS Our attention focused on the overall view on fetal surgery history, its development and perspectives. Moreover, owing to the authors' interest in plastic surgery, some remarks on the role of intrauterine medicine and surgery in this branch of medicine were made. CONCLUSIONS In utero surgery may be regarded as an efficient tool of preventive medicine. It offers some advantages that no other branch of medicine may offer. However, its implementation is more troublesome than it used to be regarded as before. Therefore only selected cases may benefit from its advantages. Nevertheless, current tendencies are to include, after thorough evaluation of benefit - risk ratio, some new indications for fetal surgery.

UI	MeSH Term	Description	Entries
D007752	Obstetric Labor, Premature	Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE).	Preterm Labor,Labor, Premature,Premature Labor,Premature Obstetric Labor,Labor, Premature Obstetric,Labor, Preterm
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011296	Prenatal Diagnosis	Determination of the nature of a pathological condition or disease in the postimplantation EMBRYO; FETUS; or pregnant female before birth.	Diagnosis, Prenatal,Fetal Diagnosis,Fetal Imaging,Fetal Screening,Intrauterine Diagnosis,Antenatal Diagnosis,Antenatal Screening,Diagnosis, Antenatal,Diagnosis, Intrauterine,Prenatal Screening,Antenatal Diagnoses,Antenatal Screenings,Diagnosis, Fetal,Fetal Diagnoses,Fetal Imagings,Fetal Screenings,Imaging, Fetal,Intrauterine Diagnoses,Prenatal Diagnoses,Prenatal Screenings,Screening, Antenatal,Screening, Fetal,Screening, Prenatal
D005260	Female		Females
D005333	Fetus	The unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. In humans, the unborn young from the end of the eighth week after CONCEPTION until BIRTH, as distinguished from the earlier EMBRYO, MAMMALIAN.	Fetal Structures,Fetal Tissue,Fetuses,Mummified Fetus,Retained Fetus,Fetal Structure,Fetal Tissues,Fetus, Mummified,Fetus, Retained,Structure, Fetal,Structures, Fetal,Tissue, Fetal,Tissues, Fetal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D013513	Obstetric Surgical Procedures	Surgery performed on the pregnant woman for conditions associated with pregnancy, labor, or the puerperium. It does not include surgery of the newborn infant.	Obstetric Surgical Procedure,Obstetrical Surgery,Obstetrical Surgical Procedures,Procedure, Obstetric Surgical,Procedures, Obstetric Surgical,Surgery, Obstetric,Surgical Procedure, Obstetric,Surgical Procedures, Obstetric,Obstetric Surgeries,Obstetric Surgery,Obstetrical Surgeries,Obstetrical Surgical Procedure,Procedure, Obstetrical Surgical,Procedures, Obstetrical Surgical,Surgeries, Obstetric,Surgeries, Obstetrical,Surgery, Obstetrical,Surgical Procedure, Obstetrical,Surgical Procedures, Obstetrical
D016239	MEDLINE	The premier bibliographic database of the NATIONAL LIBRARY OF MEDICINE. MEDLINE® (MEDLARS Online) is the primary subset of PUBMED and can be searched on NLM's Web site in PubMed or the NLM Gateway. MEDLINE references are indexed with MEDICAL SUBJECT HEADINGS (MeSH).	Index Medicus