What is Laparoscopic Fetoscopy

Laparoscopic fetoscopy is a procedure that is done during pregnancy to examine and treat the unborn baby (fetus) for certain medical conditions. The procedure involves placing a thin, lighted device (laparoscope) into the uterus through a tiny incision in the abdomen.

You may have fetoscopy to treat a problem during pregnancy. Certain problems can get worse during labor and birth or may get worse right after birth. These types of problems may need to be treated before birth.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Early rupture and leakage of fluid that surrounds the unborn baby (amniotic fluid).
• Early (preterm) labor.
• Pregnancy loss (miscarriage).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care team what steps will be taken to help prevent infection. These may include:
  • Removing hair at the incision area, if needed.
  • Washing skin with a germ-killing soap.
  • Giving you antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You may be given a medicine to help calm your baby during the procedure.
• You will be given a medicine to numb the area (local anesthetic).
• Monitoring equipment will be attached to your belly (abdomen) to check your baby’s heart rate during the procedure.
• Ultrasound images of your baby and your uterus will guide the health care provider during surgery.
• The health care provider will make a small incision and insert a special instrument (trocar) that will be used to enter your abdomen and uterus.
• The health care provider will remove the trocar and insert the laparoscope into the uterus.
• Images of your baby will be projected on a computer screen.
• The health care provider will use the laparoscope to perform all exams, testing, and treatment.
• The health care provider will remove the laparoscope. The tissues of your uterus and your skin will be closed with a few stitches (sutures).
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may need to stay in a recovery area after the procedure so your health care provider can monitor your baby and make sure there are no signs of premature labor or ruptured membranes.
• If you also had another procedure done during the fetoscopy, your health care provider will give you instructions for follow-up care.

Summary

• Laparoscopic fetoscopy is a procedure that is done during pregnancy to examine and treat the unborn baby (fetus) for certain conditions.
• Generally, fetoscopy is a safe procedure.
• Follow instructions from your health care provider before and after the procedure.

Laparoscopic Fetoscopy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild cramping.
• Mild soreness near the incision area.
• Slight leaking of fluid or discharge from the vagina.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not take baths, swim, or use a hot tub until your health care provider says it is okay to do so. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• If your health care provider recommends activity restriction called pelvic rest:
  • Do not have sexual intercourse until your health care provider says it is safe.
  • Avoid activities that require a lot of effort.
  • Avoid any activity that may strain the muscles of your lower belly (pelvic muscles), such as squatting.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Talk with your health care provider about when you may return to work and your normal exercise routine.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• If told by your health care provider, schedule an ultrasound the day after the procedure to monitor the status of your baby. An ultrasound is a test that uses sound waves and a computer to make images.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have chills or a fever.
• Have low back pain.
• Have a change in vaginal discharge.
• Become dizzy.
• Have redness, swelling, or pain in your incision area, and those symptoms get worse.
• Have fluid that is leaking from the incision area, and that fluid:
  • Increases over time.
  • Becomes thick or yellow or it smells bad.

Get help right away if you:

• Have cramps or contractions.
• Have severe pain in your back or abdomen.
• Have persistent leaking or gushing of fluid from your vagina.
• Have bleeding from your vagina.
• Do not feel your baby move.

Summary

• This sheet gives you information about how to care for yourself after your procedure.
• After the procedure, it is common to feel mild cramping and soreness and have slight leaking of fluid or discharge from the vagina.
• Make sure you know which symptoms should cause you to contact your health care provider.
• Get help right away if you get contractions, have severe pain in your back or abdomen, have blood or a lot of fluid coming from your vagina, or do not feel your baby move.