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Fetal therapy was first used in 1963 with exchange transfusion for haemolytic disease of the newborn, once a serious problem (see also rhesus factor). Today the use of fetal therapy remains limited. Most treatments involve needling: introducing fine instruments through the mother's abdominal and uterine walls under ultrasound guidance. Open-womb surgery (hysterotomy) remains controversial because of the risks involved. It is available only in some centres in the USA.
The sun of freedom rises from the Caribbean Sea. The stars represent Costa Rica's seven provinces. Red was added to the blue and white flag to reflect the French tricolour. Effective date: 29 September 1848.
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