ENDOSCOPIC INTRAUTERINE FETAL THERAPY - A MONKEY MODEL

Objectives. Prenatal ultrasonographic investigations have led to an in creasing number of prenatally detected abnormalities, of which a large number involves the urogenital tract. This study was performed to eva luate if endoscopic intra-amniotic access is possible in primates. Met hods. In 10 midtrimester rhesus monkeys (Macaca mulatta), endoscopic i ntrauterine fetoscopy was performed with three access cannulas. Using a Seldinger technique, a vascular access system, and a pediatric lapar oscopy set, intra-amniotic inspection was attempted. Fetal growth thro ughout pregnancy was monitored by ultrasonographic measurements of fet al biometry. Results. Intrauterine access could successfully be achiev ed in 10 rhesus monkeys with three cannulas. After partial amniotic fl uid exchange, adequate fetoscopy was always possible. Two monkeys abor ted on the second and sixth postoperative days. Serial ultrasonographi c investigations for fetal biometry showed no disturbance of the intra uterine growth patterns in the remaining 8 monkeys. Conclusions. We cu rrently conclude that the rhesus monkey model for experimental intraut erine endoscopic surgery may be suitable for study of the developmenta l abnormalities of the genitourinary tract.