DIAGNÓSTICO - FEVEREIRO 2022
What do you think is the most difficult part when you do the surgery in utero? People involved in fetal surgery must be very good in ultrasound scanning so that they can orientate themselves. Unlike postnatal surgery where you have a patient in front of you, in fetal surgery you need to have a 3 dimensional mind so you can visualise the patient inside the uterus by using ultrasound so you can orientate yourself. I think that is the most difficult part of fetal surgery orientation with the patient that is one step removed from you separated by the uterine wall. In your opinion, what are the most prominent concerns “Unlike postnatal surgery facing fetal care nowadays? where you have a patient Fetal medicine has expanded in front of you, in fetal into the major field of its surgery you need to have a own and it is important 3 dimensional mind so you that people involved in this field should receive can visualise the patient extensive training. They inside the uterus by using have to become very good in ultrasound so you can ultrasound scanning, so they orientate yourself.” can diagnosed a series of fetal abnormalities but they also need to be aware of many developments in molecular biology and genetics so that they can interpret better the results of what they see by ultrasound. They can monitor fetal growth for example, and found out if the babies are not growing well and then to decide when is the best time to deliver these babies. They have to be good in ultrasound, they have to be good in obstetrics and know how to manage pregnancies. Equally, they also have to be good in genetics so they can explain the abnormalities that they see. What does the future hold for fetal medicine research? Over the last thirty to forty years, we have developed the methods that we are using now for fetal surgery. I think that the number of conditions that have been unnameable for fetal surgery is very small so I don’t really expect major developments in discovering new conditions that would benefit from intrauterine surgery. However, many genetic diseases are potentially correctable by intrauterine stem cell transplantation or gene therapy. Therefore, I expect that major emphasis of research will be in the area of intrauterine stem cell transplantation and gene therapy.
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