Therapy in utero

The term therapy in utero , also known by the synonyms fetal therapy and prenatal therapy, refers to the prenatal (in utero = within the uterus ) treatment of diseases and malformations of the embryo or fetus that have been diagnosed using prenatal diagnostic procedures and with the The currently available technical, medicinal and surgical options can be treated.

The aim of therapy in utero is the most extensive medical-therapeutic treatment of the unborn child so that an existing or developing disease or malformation that, if left untreated, would in any case or at least potentially lead to damage to the baby, is cured or its progression is stopped or . is delayed. This is to ensure that the child is born as punctually as possible , which ideally can be viable in the long term without permanent damage through fetal therapy.

Methods of prenatal therapy are usually indicated up to about the 32nd week of pregnancy. After this point in time, the initiation of childbirth with the aim of treating the child outside the womb is usually associated with lower risks than therapy in utero.

The diseases that can potentially be treated in utero include: B. adrenogenital syndrome (AGS), heart failure , rhesus intolerance (treatment method: blood transfusion via the umbilical cord ), ectodermal dysplasia (treatment with a replacement protein for the missing messenger substance) as well as various obstructions (treatment method: installation of an artificial shunt or puncture for Restoration of permeability). A separation of vascular connections, which can trigger the fetofetal transfusion syndrome in twins , is also possible in some cases prenatal. Surgical closures of forms of the spina bifida aperta are also increasingly being performed prenatally.

See also

• Fetal surgery

literature

• Rolf Becker, Walter Fuhrmann, Wolfgang Holzgreve u. a .: Prenatal diagnosis and therapy - human genetic counseling, etiology and pathogenesis of malformations, invasive, non-invasive and sonographic diagnosis as well as therapy in utero (1995)
• Barbara Maier: Ethics in Gynecology and Obstetrics. Decisions based on clinical case studies (2000) Table of contents ( Memento from October 17, 2004 in the Internet Archive )

Web links

• Ärzteblatt: In-utero diagnosis and therapy of congenital heart defects: limits and possibilities

Individual evidence

1. ↑ Richard Friebe: HELPFUL: Molecular therapy in the womb. Retrieved December 22, 2018 . 
2. ↑ UMM: Spina bifida (open back): University Hospital Mannheim. Retrieved August 1, 2018 . 

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