Second-trimester fetoscopy and fetal blood sampling: Current limitations and problems☆☆☆

Abstract Throughout pregnancy, fetal medical care is compromised by the inaccessibility of the fetus. In the second trimester, the diagnosis of fetal disease could be significantly improved by direct visualization of the fetus (fetoscopy) and by direct access to fetal tissue or blood. This report documents our initial experiences with second-trimester fetoscopy and fetal blood sampling in the pregnant ewe and in the pregnant woman. The potential diagnostic and therapeutic applications of fetoscopy and the current limitations and problems identified in our studies are presented. In light of our experience, and because of the many unanswered questions which remain concerning the safety and methodology of fetoscopy, we conclude that further instrument modification and research are required before second-trimester fetoscopy and fetal tissue sampling can be accepted as a simple, safe, and practical clinical approach.