{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:40Z","timestamp":1753876300452,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["Ko 1484\/1-1, Ko 1484\/2-1, Ko 1484\/3-1, Ko 1484\/3-2, Ko 1484\/3-3"],"award-info":[{"award-number":["Ko 1484\/1-1, Ko 1484\/2-1, Ko 1484\/3-1, Ko 1484\/3-2, Ko 1484\/3-3"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Some foetuses scheduled for balloon valvuloplasty present with unfavourable lies that render a successful procedure unlikely or impossible. In these situations, foetal posturing previously has been achieved by maternal laparotomy. As a less invasive means, we demonstrate the feasibility of a minimally invasive foetoscopic approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>Percutaneous ultrasound-guided foetal balloon valvuloplasty for severe aortic valve stenosis was attempted in a human foetus at 29\u2009+\u20094\u2009weeks of gestation under general maternofoetal anaesthesia. Unfortunately, prior to the procedure, the foetus had been observed on several occasions remaining in a dorsoanterior cephalic position. Therefore, the left ventricle could not be accessed by the conventional percutaneous ultrasound-guided approach. In order to achieve the desired foetal lie, foetoscopic assistance was employed: using a standardized foetoscopic setup, a foetoscope and two graspers, the foetus was rotated in dorsoposterior position. After this manoeuver, successful balloon valvuloplasty was achieved. Mother and foetus tolerated the procedure well and complications were not observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Foetoscopy-assisted foetal posturing offers itself as an alternative to maternal laparotomy in foetuses presenting with a persisting disadvantageous position at the time of balloon valvuloplasty. Due to the increased risks of preterm rupture of membranes and earlier delivery posed by the foetoscopic approach, this technique may preferably be used in more mature foetuses when foetal posturing cannot be achieved by other means.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab293","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T15:32:53Z","timestamp":1627054373000},"source":"Crossref","is-referenced-by-count":1,"title":["Foetoscopy-assisted balloon valvuloplasty in a human foetus with disadvantageous intrauterine position: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3097-2479","authenticated-orcid":false,"given":"Thomas","family":"Kohl","sequence":"first","affiliation":[{"name":"German Center for Fetal Surgery & Minimally-Invasive Therapy (DZFT), Mannheim University Hospital (UMM), Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Akin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mannheim University Hospital (UMM), Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliane","family":"Frommberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mannheim University Hospital (UMM), Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadja","family":"Riehle","sequence":"additional","affiliation":[{"name":"German Center for Fetal Surgery & Minimally-Invasive Therapy (DZFT), Mannheim University Hospital (UMM), Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Schranz","sequence":"additional","affiliation":[{"name":"German Center for Fetal Surgery & Minimally-Invasive Therapy (DZFT), Mannheim University Hospital (UMM), Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,15]]},"reference":[{"key":"2021081518310864000_ytab293-B1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1136\/hrt.65.5.256","article-title":"Balloon aortic valvuloplasty in the fetus: a report of two cases","volume":"65","author":"Maxwell","year":"1991","journal-title":"Br Heart J"},{"key":"2021081518310864000_ytab293-B2","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/S0002-9149(00)00733-5","article-title":"World experience of fetal cardiac intervention in human fetuses with severe aortic valvar obstruction","volume":"85","author":"Kohl","year":"2000","journal-title":"Am J 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