Extracorporeal high intensity focused ultrasound treatment of the placental unit: In vivo study using a monkey model of pregnancy

The last 20 years have seen the development of fetal surgery, particularly for the treatment of twin-to-twin transfusion syndrome (TTTS). Although fetoscopy increases survival rate, it is also invasive and responsible for fetal and maternal complications affecting the neonatal outcome. A completely non-invasive treatment that could occlude deep anastomoses would prevent the risks of invasive fetoscopy while offering the potential for more effective therapy. We previously developed a toroidal HIFU transducer that enables the destruction of large tissue volumes. The effectiveness of this HIFU device applied to the perfused placental unit must now be studied in a preclinical animal study under conditions similar to those in humans before starting a clinical trial. We report here the first use of a completely non-invasive treatment of the placenta in pregnant animals.