Test Overview

Fetoscopy is done during pregnancy to allow a doctor to see the fetus through a thin, flexible instrument called a fetoscope. The fetoscope is inserted into the uterus through a small cut (incision) made in the belly. Fetal ultrasound is used to guide the placement of the fetoscope to protect the fetus. A camera can be attached to the fetoscope to take pictures.

Fetoscopy is usually done during or after the 18th week of a pregnancy. At this time, the structures of the placenta and the fetus are developed enough to be able to diagnose a serious problem.

Why It Is Done

Fetoscopy is done to:

• Evaluate the fetus for birth defects, such as spina bifida. Fetoscopy can detect some birth defects and inherited diseases that cannot be found by other tests.
• Collect samples of blood from the umbilical cord. The samples can be tested for diseases such as hemophilia or sickle cell anemia.
• Collect samples of tissue (usually skin) from the fetus. The tissue can be tested for some inherited diseases.

Because fetoscopy may cause problems for the mother and fetus, it is done only if there is a high chance the fetus is not normal or there is a strong family history of birth defects. It usually is available only at large medical centers.

How To Prepare

Do not eat or drink for 8 hours before having fetoscopy. You may be given antibiotics before the procedure to prevent an infection.

You will need to sign a consent form that says you understand the risks of fetoscopy and agree to have the test done. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may indicate. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?) .

How It Is Done

Before fetoscopy

• Your doctor will check the fetal heart rate.
• You may be given medicine such as meperidine (Demerol) to prevent the fetus from moving around a lot.

During the procedure

• You will be instructed to take off your clothes below the waist and drape a paper or cloth covering around your waist.
• You will then lie on your back with your upper body slightly raised to relax your stomach muscles.
• Your lower abdomen will be cleaned with antiseptic, and you will be given an injection of medicine to numb the skin where the fetoscope will be inserted.
• You will also be given a sedative to help you relax and to reduce fetal movement during the procedure.
• The doctor will determine the position of the fetus and the placenta using fetal ultrasound scanning. Ultrasound uses reflected sound waves to create a picture of the uterus, fetus, placenta, and amniotic fluid on a video screen.
• With the ultrasound picture as a guide, your doctor will select the best place to make a small cut in your belly and uterus and then insert the fetoscope directly into the uterus. The doctor can then look at the fetus, collect samples of fetal blood or skin, and operate on the fetus if needed.

After the procedure

• The fetoscope is removed, the incision is closed with stitches, and a bandage is applied.
• Fetal ultrasound may be repeated to check for fetal movement and evaluate the level of amniotic fluid.
• You and your fetus will be monitored for several hours after the procedure.
• Ultrasound will be repeated the day after the fetoscopy to check the fetus and the placenta.

The entire procedure takes from 1 to 2 hours.

How It Feels

When you receive the injection to numb the skin around the needle site, you will feel sharp stinging or burning for a few seconds. A sedative will help you and your fetus relax; this should reduce the amount of discomfort you feel. While the fetoscope is in your uterus, you may feel some pain or pressure.

After the procedure, you may feel faint or nauseated or have some mild abdominal cramping. Avoid strenuous activity for 1 to 2 weeks following fetoscopy. Then you can continue your normal activities, unless your doctor advises otherwise.

Risks

Risk associated with fetoscopy include:

• Miscarriage, which can be as high as 12% (12 in every 100 tests), especially if another surgical procedure is done during fetoscopy.
• Excessive bleeding, infection, or excessive leakage of the amniotic fluid.
• Preterm rupture of the membranes (PROM) that requires early delivery of the fetus.
• Mixing the blood of the mother and fetus. Therefore, unless the fetus's father has Rh-negative blood, an Rh-negative woman will be given an injection (Rho-GAM) to prevent Rh sensitization, which could harm her fetus if it has Rh-positive blood.

After the test

Call your doctor right away if you have:

• Moderate or severe abdominal pain or cramping.
• Chills or a fever.
• Dizziness.
• Fluid or blood leaking from your vagina or from the cut in your belly.

Results

Fetoscopy is done during pregnancy to allow a doctor see the fetus through a thin, flexible instrument called a fetoscope. The fetoscope is inserted into the uterus through a small cut made in the belly.

Many factors can change fetoscopy results. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and medical history.

Visible results are usually ready right away. Results of blood or skin tissue biopsies may take several days.

What Affects the Test

Fetoscopy results may be affected by:

• Being very overweight or obese.
• Amniotic fluid that is extremely cloudy.
• A very active fetus.
• Not being able to lie still during the test.

What To Think About

• Fetal ultrasound is used to guide the placement of the fetoscope so that the fetus is not harmed. For more information, see the medical test Fetal Ultrasound.
• Fetoscopy is usually done only for women who have a high risk of having a child with a major birth defect that can be found only using fetoscopy. Other tests (such as amniocentesis, chorionic villus sampling, and fetal ultrasound) can detect many birth defects and inherited diseases and have a lower risk of causing problems. For more information, see the medical tests Amniocentesis, Chorionic Villus Sampling, and Fetal Ultrasound.
• Surgical procedures using fetoscopy are being developed. Surgery has been used to correct problems such as abnormal blood flow between twin fetuses and a condition called amniotic bands that can deform limbs and other structures in a fetus. However, this type of surgery is still experimental.
• The skill of the doctor who does the fetoscopy is important. Doctors experienced in performing fetoscopy have fewer problems resulting from the procedure.
• Fetoscopy is usually available only at large medical centers.