ABSTRACT
In the 1970s, direct fetal visualization through endoscopy was introduced into obstetrics. Various names were given to this technique: amnioscopy, fetoscopy, or embryoscopy, the latter referring to its application in the first trimester. Fetoscopy was performed for diagnostic purposes, e.g., to obtain fetal blood in the diagnosis of hemoglobinopathies, to demonstrate pathognomic malformations or to biopsy fetal skin or liver under direct vision. Fetoscopy was also used for therapeutic purposes, such as intravascular transfusion under direct visual control. The technique never became widely implemented because of its required skills, instruments, and invasiveness. The overall abortion rate, defined as any fetal loss prior to 28 weeks, was 4%. Abortions were more frequent following skin biopsy (16%) and fetal visualization (7.9%). The relatively large diameter of the instruments used may have played a role: rod lens telescopes of 3 mm were the minimum for sufficient illumination and appropriate image resolution. As a consequence, instruments were also much shorter than what is used today. Some complications were also attributed to the ‘‘blind’’ introduction technique, i.e., without ultrasound (US) guidance. Anyway, fetoscopy soon was nearly completely abandoned because of advances in high-resolution US, used for diagnostic purposes or to guide invasive procedures.
