An innovative model of endotracheal catheter (FETO-balloon) for fetal endoscopic tracheal occlusion in severe congenital diaphragmatic hernia


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Abstract

The paper presents the data available in the literature on the etiology and pathogenesis of congenital fetal malformations, treatments for congenital diaphragmatic hernias, and fetoscopic endotracheal occlusion (FETO) procedure. It describes the first Russian model of a fetal endoscopic tracheal occlusion catheter (FETO balloon) designed at the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. The novel model consists of a 10-cm distal part with a balloon and a 50-cm proximal one with a channel for administration of saline solution into the cuff of the inflatable balloon with the possibility of separating the distal part from the proximal one. The patient selection criteria for the use of the endotracheal catheter (FETO balloon) are singleton pregnancy, confirmed diagnosis of severe or extremely severe fetal diaphragmatic hernia, and a patient’s signed informed consent form. The prerequisite is the prevention of respiratory distress syndrome before FETO or/and when the signs of threatening preterm birth appear at 24 to 34 weeks’ gestation. The delivery period is 37-38 weeks. Caesarean section is a method for delivery; EXIT is a procedure for balloon removal. Conclusion. The introduction of the first innovative Russian model of an endotracheal catheter for fetal endoscopic tracheal occlusion in severe congenital diaphragmatic hernia will be able to avoid repeatedfetoscopic interventions aimed at antenatal balloon removal, thereby lowering the risk of intraoperative maternal and fetal complications.

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About the authors

M. G Schneiderman

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: innamike@lmi.net
PhD, obstetrician-gynecologist 117997, Russia, Moscow, Ac. Oparina str., 4

A. A Burov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: burovmd@gmail.com
Head of Clinical Affairs, Department of Newborn Surgery 117997, Russia, Moscow, Ac. Oparina str., 4

Yu. I Naberezhnev

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: rubick@yandex.ru
PhD, Head of the Department of Organization of Perinatal Care 117997, Russia, Moscow, Ac. Oparina str., 4

Yu. L Podurovskaya

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

PhD, Head of Department of Newborn Surgery 117997, Russia, Moscow, Ac. Oparina str., 4

N. K Tetruashvili

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: tetrauly@mail.ru
Dr. Med. Sci., Deputy Director, Institute of Obstetrics; Head of the 2nd Obstetrics Department of Pathology of Pregnancy 117997, Russia, Moscow, Ac. Oparina str., 4

R. G Shmakov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: mdshmakov@mail.ru
Dr. Med. Sci., Professor of RAS, Director of the Institute of Obstetrics 117997, Russia, Moscow, Ac. Oparina str., 4

G. T Sukhikh

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: gsukhikh@oparina4.ru
Dr. Med. Sci., Professor, Academician of RAS, Director 117997, Russia, Moscow, Ac. Oparina str., 4

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