Fetoendoscopy, The author replies

The precision lent by Akgu¨ r and Olguner to our experimental model of gastroschisis using fetoendoscopy is altogether welcome. The distinctions they make are good ones semantically. They are correct when they say that amniotic fluid (AF)exchange is different from amnioinfusion. Both methods are used to lower the intraamniotic meconium concentration. AF exchange can be used in all cases (with or without oligohydramnios), and we think that it will probably prove to be superior to amnioinfusion alone, which is already used in clinical cases with severe oligohydramnios [1, 4, 5]. In our study, we implanted a subcutaneous port so as to minimize repetitive utero puncture and then be able to perform the AF exchange several times, far more often than actually acceptable in clinical practice. However, tolerance was not as good as we had hoped [2], even in ewes. The induction of fetal diuresis by furosemide as proposed by Hakgu¨ der et al. seems to be a promising alternative therapy [3].