TRANSABDOMINAL NEEDLE EMBRYOFETOSCOPY - A NEW TECHNIQUE PAVING THE WAY FOR EARLY FETAL THERAPY

Objective: To explore the feasibility of using a newly devised needle endoscope to conduct transabdominal first-trimester endoscopy for both embryonic visualization and blood sampling. Methods: Following inform ed consent, 12 patients at 8-12 weeks' gestation undergoing first-trim ester termination were invited to participate in this study. Transabdo minal needle embryofetoscopy was also performed in one continuing preg nancy. A specially designed 16-gauge, double-barrel instrument sheath equipped with 0.8-mm fiberoptic endoscope and a customized 27-gauge he parinized needle were passed transabdominally under ultrasound guidanc e through the uterine wall and into the exocoelomic space. Results: Us ing first-trimester transabdominal needle embryofetoscopy, we were abl e to identify the normal anatomical. landmarks of the embryo and were also able to gain access to the embryonic circulation by advancing the 27-gauge needle into the umbilical vessels. In addition, we were able to infuse indigo carmine dye into the fetal circulation of three subj ects. Needle embryofetoscopy was also used in a continuing pregnancy f or prenatal diagnosis. Conclusion: Our experience establishes the feas ibility of first-trimester transabdominal needle embryofetoscopy for e mbryonic visualization and access to the circulation. This new develop ment is expected to serve as a basis for further studies attempting to diagnose and treat congenital diseases in early pregnancy.