Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Section 1 General principles
- Section 2 Fetal disease
- Chapter 6 Red cell alloimmunization
- Chapter 7 Fetal and neonatal alloimmune thrombocytopenia
- Chapter 8.1 Fetal dysrhythmias
- Chapter 8.2 Fetal dysrhythmias
- Chapter 9.1 Structural heart disease
- Chapter 9.2 Structural heart disease
- Chapter 9.3 Structural heart disease
- Chapter 10.1 Manipulation of amniotic fluid volume
- Chapter 10.2 Manipulation of amniotic fluid volume
- Chapter 11.1 Twin-to-twin transfusion syndrome
- Chapter 11.2 Twin-to-twin transfusion syndrome
- Chapter 11.3 Twin-to-twin transfusion syndrome
- Chapter 11.4 Twin-to-twin transfusion syndrome
- Chapter 11.5 Twin-to-twin transfusion syndrome
- Chapter 12.1 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 12.2 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 13.1 Fetal infections
- Chapter 13.2 Fetal infections
- Chapter 14.1 Fetal urinary tract obstruction
- Chapter 14.2 Fetal urinary tract obstruction
- Chapter 14.3 Fetal urinary tract obstruction
- Chapter 14.4 Fetal urinary tract obstruction
- 15.1 Fetal lung growth, development, and lung fluid
- Chapter 15.2 Fetal lung growth, development, and lung fluid
- Chapter 16.1 Neural tube defects
- Chapter 16.2 Neural tube defects
- Chapter 17.1 Fetal tumors
- Chapter 17.2 Fetal tumors
- Chapter 18.1 Intrauterine growth restriction
- Chapter 18.2 Intrauterine growth restriction
- Chapter 19.1 Congenital diaphragmatic hernia
- Chapter 19.2 Congenital diaphragmatic hernia
- Chapter 20.1 Fetal stem cell transplantation
- Chapter 20.2 Fetal stem cell transplantation
- Chapter 20.3 Fetal stem cell transplantation
- Chapter 21 Gene therapy
- Chapter 22 The future
- Glossary
- Index
- References
Chapter 22 - The future
Fetal therapy and translational studies: global alignment, coordination, and collaboration in perinatal research: The Global Obstetrics Network (GONet) initiative
from Section 2 - Fetal disease
Published online by Cambridge University Press: 05 February 2013
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Section 1 General principles
- Section 2 Fetal disease
- Chapter 6 Red cell alloimmunization
- Chapter 7 Fetal and neonatal alloimmune thrombocytopenia
- Chapter 8.1 Fetal dysrhythmias
- Chapter 8.2 Fetal dysrhythmias
- Chapter 9.1 Structural heart disease
- Chapter 9.2 Structural heart disease
- Chapter 9.3 Structural heart disease
- Chapter 10.1 Manipulation of amniotic fluid volume
- Chapter 10.2 Manipulation of amniotic fluid volume
- Chapter 11.1 Twin-to-twin transfusion syndrome
- Chapter 11.2 Twin-to-twin transfusion syndrome
- Chapter 11.3 Twin-to-twin transfusion syndrome
- Chapter 11.4 Twin-to-twin transfusion syndrome
- Chapter 11.5 Twin-to-twin transfusion syndrome
- Chapter 12.1 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 12.2 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 13.1 Fetal infections
- Chapter 13.2 Fetal infections
- Chapter 14.1 Fetal urinary tract obstruction
- Chapter 14.2 Fetal urinary tract obstruction
- Chapter 14.3 Fetal urinary tract obstruction
- Chapter 14.4 Fetal urinary tract obstruction
- 15.1 Fetal lung growth, development, and lung fluid
- Chapter 15.2 Fetal lung growth, development, and lung fluid
- Chapter 16.1 Neural tube defects
- Chapter 16.2 Neural tube defects
- Chapter 17.1 Fetal tumors
- Chapter 17.2 Fetal tumors
- Chapter 18.1 Intrauterine growth restriction
- Chapter 18.2 Intrauterine growth restriction
- Chapter 19.1 Congenital diaphragmatic hernia
- Chapter 19.2 Congenital diaphragmatic hernia
- Chapter 20.1 Fetal stem cell transplantation
- Chapter 20.2 Fetal stem cell transplantation
- Chapter 20.3 Fetal stem cell transplantation
- Chapter 21 Gene therapy
- Chapter 22 The future
- Glossary
- Index
- References
Summary
Introduction
Medical interventions should only be offered if there is evidence that they help the patient. At present, there is consensus that their effectiveness should be evaluated before incorporation into guidelines.
Since the inception of fetal medicine as a subspecialty and the application of in-utero treatments for fetal therapy, there have been cohort studies presented. Initially these cohort series (mainly retrospective) were based on experiences from tertiary centers but in the last five to ten years there has been more of a focus on “population-based” cohort studies that at least have accurate denominator data from which to calculate outcomes.
Critical appraisal of the literature and appraisal of fetal therapy has been aided by performing systematic reviews and, where practicable, meta-analysis of outcomes. However, although such methods are informative they summate evidence from relatively small and often heterogeneous case cohort studies.
The randomized clinical trial is considered to be the best research tool to evaluate the effectiveness of medical interventions, and is the widely acknowledged design of choice for evaluating medical and surgical treatments [1 – 3].
Keywords
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- Fetal TherapyScientific Basis and Critical Appraisal of Clinical Benefits, pp. 433 - 439Publisher: Cambridge University PressPrint publication year: 2012