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Fetoscopic Management of Complicated Monochorionic Twins


Clinical Obstetrics and Gynecology: December 2009 - Volume 52 - Issue 4 - p 647-653
doi: 10.1097/GRF.0b013e3181beda76
Surgical Intervention in Pregnancy

Operative fetoscopy is a surgical approach to the in utero treatment of fetal or placental abnormalities. The approach is on the basis of combined use of ultrasound and endoscopy and minimally invasive access into the womb. Operative fetoscopy is associated with significantly less risk of preterm birth, neonatal morbidity, and maternal morbidity as compared with open fetal surgery. A wide variety of fetal conditions have been surgically managed via operative fetoscopy, particularly complicated monochorionic twin gestations. The aim of this chapter is to review the current status and future direction of operative fetoscopy for the treatment of complicated monochorionic twin pregnancies.

*Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, Florida

Correspondence: Rubén A. Quintero, MD, Division of Maternal Fetal Medicine, Director University of Miami/Jackson Memorial Hospital Fetal Therapy, 1611 NW 12th Avenue, Holtz 4061, Miami, FL 33136. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.