DIAGNOSTIC EMBRYOSCOPY AND FETOSCOPY IN THE FIRST-TRIMESTER OF PREGNANCY

Embryoscopy is the examination of the embryo at 9-10 weeks' gestation through the intact membranes by introducing an endoscope into the exoc oelomic space transcervically or transabdominally. This is likely to r emain confined to the management of early pregnancy in selected famili es affected by recurrent genetic syndromes with recognizable external fetal abnormalities. The procedure-related risk of fetal loss is aroun d 12 per cent. Fetoscopy is the examination of the fetus after 11 week s' gestation. This is performed transabdominally in the amniotic fluid . The technique has evolved with the miniaturization of the optical de vice by using fibre-optics technology. This procedure is likely to fin d new applications with the development of ultrasound examination at 1 0-14 weeks' gestation in order to, either confirm, or rule out suspect ed external fetal abnormalities. Amniocentesis can be performed al the same time. The procedure-related risk is likely to remain below 10 pe r cent but no accurate figures can be drawn from the literature. (C) 1 997 by John Wiley & Sons, Ltd.