Thesis

Assessment of fetoscopic tracheal occlusion using ultrasound images in phantom study

Downloadable Content

Download PDF
Creator
Rights statement
Awarding institution
  • University of Strathclyde
Date of award
  • 2014
Thesis identifier
  • T13903
Qualification Level
Qualification Name
Department, School or Faculty
Abstract
  • Congenital Diaphragmatic Hernia (CDH) is a birth defect that affects approximately 1 in 2000-5000 neonates. Most of the CDH cases are isolated, which means that affected individuals have no other major malformations. The diaphragm is a muscle that separates the chest from the abdomen. Incomplete fetal diaphragm formation results in a hernia that allows the abdominal organs to move into the chest and crowd the heart and lungs. This crowding can lead to pulmonary hypoplasia. Newborns with underdeveloped lungs have severe respiratory insufficiency. The outcome of fetuses with CDH may be improved by fetal endoscopic tracheal occlusion (FETO). During pregnancy, fetal lungs secrete fluid into the amniotic cavity through the airways. FETO is a minimally invasive therapy which objective is to stimulate pulmonary growth. Through a small incision in the skin a very small fetoscope is inserted and advanced through the mouth of the fetus down to the trachea, where a detachable balloon is inflated. The fetus is left with the balloon inside the trachea with a completely obstructed airway and after 3-6 weeks it is removed by endoscopy. The obstruction of the trachea prevents the egress of pulmonary fluid triggering lung expansion and growth and decreasing pulmonary hypoplasia. Even though FETO saves many babies' life, the procedure has some drawbacks. Surgeons make use of rigid fetoscopes to introduce the balloon into the trachea. Fetuses are forced to be in a hyperextended neck position during the surgery so that the access to the trachea is possible. There are many concerns about the cervical vertebrae stress and fetal distress that the hyperextension could cause to the fetus. The fetal neck positions throughtout the surgery were assessed and measured by means of ultrasound images. The results show that the babies undergo a neck hyperextension of great magnitude that undoubtedly might lead to fetal damage and distress.
Resource Type
DOI
Date Created
  • 2014
Former identifier
  • 1041968

Relations

Items

Thumbnail Title Date Uploaded Visibility Actions
file details PDF of thesis T13903 2021-07-02 Public Download