In the recent past, the first opportunity to visualize fetal structure and function occurred at birth. Two major contributions in the 1960s inaugurated the era of the fetus as a patient: (1) Prenatal diagnosis became possible using amniocentesis as a technique to evaluate fetal health by cytogenetic1 and biochemical2,3 analysis. (2) Prenatal treatment became possible using fetal transfusion to control rhesus factor erythroblastosis fetalis.4 Intrauterine exchange transfusions through an open abdomen and uterine incision were attempted and abandoned due to unacceptably high maternal morbidity associated with "open" procedures.5 The development of less invasive techniques for percutaneous placement of catheters or needles for intraperitoneal transfusion permitted in utero exchange transfusion.6
In the 1970s, the introduction of fetal ultrasonography allowed for accurate visualization of the structure and function of the fetus.7 As skill and technology advanced, the list of fetal anomalies able to be diagnosed by
Evans MI, Drugan A, Manning FA, Harrison MR. Fetal Surgery in the 1990s. Am J Dis Child. 1989;143(12):1431–1436. doi:10.1001/archpedi.1989.02150240053016
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