| Fetal Therapy. |
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In Bai Chung |
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Department of Obstetrics and Gynecology, Wonju College of Medicine, Yonsei University, Korea. ibchung@yonsei.ac.kr |
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| Abstract |
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Since fetal therapy is a newly developed field as a pioneer during the last few decades, initial activity before the year 2002 was based on successful case reports and case series. However, multicenter randomized controlled trial with the comparison to the previous standard treat should be needed for the establishment of new therapy. This philosophy of evidence-based clinical practice is now accepted after 2002. New randomized trials are being published in the literature. (eq. fetal endoscopic tracheal occlusion for congenital diaphrag-matic hernia and laser treatment of the twin-to-twin transfusion syndrome) Another trends of fetal therapy are efficacy after the evaluation of long-term outcomes and minimal invasive access methods in both diagnosis and surgery. The option of middle cerebral artery doppler examination for the diagnosis of fetal anemia is newly available besides invasive repeated-cordocentesis. Measurement of cell-free fetal DNA levels in the maternal circulation rather than invasive chorionic villi sampling is gradually phasing into clinical use for non-invasive method to diagnose fetal single gene disorders. In Utero Hematopoietic Stem Cell Transplantation offers a potential way to treat fetuses with immunodeficiency diseases among the congenital hematologic disorders. Successful Stem Cell Transplantation for other congenital hematologic disorders and specific gene therapy will hopefully come true in the near future after further developmental expansion of ethical, technical fields. |
| Key Words:
Fetal therapy, Evidence-based clinical practice, Minimal invasive access |
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