Fetoscopy is the use of a small endoscope during pregnancy to see structures inside the amniotic cavity or on the placental surface. The instrument is introduced through a carefully planned access route, usually under continuous ultrasound guidance. Additional small ports may be required for some operations.
Why fetoscopy may be used
Fetoscopy can provide direct visual access for procedures such as laser ablation of placental vascular connections in twin-to-twin transfusion syndrome, balloon placement or removal in FETO, and selected forms of prenatal spina bifida repair. The exact instrument, number of ports, anaesthesia, and operating conditions depend on the procedure.
Planning access
The team maps placental position, cord insertions, fetal position, amniotic fluid, cervix, uterine anatomy, maternal abdominal access, and previous scars. A technically difficult route may increase risk or make another plan safer.
Risks
Potential complications include fluid leakage, preterm prelabour rupture of membranes, bleeding, infection, contractions, placental or membrane injury, fetal injury, pregnancy loss, preterm birth, inability to complete the planned procedure, and the need for repeat intervention or emergency delivery. Risks differ substantially between procedures and should be discussed using programme-specific outcomes rather than one generic percentage.
After the procedure
Monitoring may include maternal observations, pain and bleeding assessment, ultrasound, fetal heart-rate assessment, cervical review, and surveillance for contractions or fluid loss. Discharge instructions should specify who to call and where to attend.
Urgent evaluation is needed for heavy bleeding, fluid leakage, fever, worsening abdominal pain, regular contractions, reduced fetal movements, breathing difficulty, or feeling acutely unwell.
Fetoscopic procedures are coordinated through the UAE programme at Mediclinic Airport Road Hospital. The dated programme-status panel gives current pathway classifications, and every procedure remains subject to case-specific eligibility, governance, and informed consent.
The essential distinctions
Access is only one part of fetal surgery.
Imaging and safety planning determine whether an access route and a proposed intervention are suitable.
- Map the placenta
Placental position and anatomy affect the possible route and the risk discussion.
- Define the target
The planned intervention must address a specific mechanism that can change an outcome.
- Protect the pregnancy
Membranes, maternal safety, preterm birth, rescue plans, and follow-up are part of the decision.