Early vesico-amniotic shunting - does it change the prognosis in fetal lower urinary tract obstruction diagnosed in the first trimester?

The aim of the study was to assess the outcome of vesico-amniotic shunting performed before 16 weeks of pregnancy in fetuses with severe megacystis diagnosed in the first trimester of pregnancy. Between January 2008 and October 2012 severe megacystis with the bladder length > 15 mm was diagnosed...

Full description

Saved in:
Bibliographic Details
Published in:Ginekologia polska 2017-01, Vol.88 (9), p.486-491
Main Authors: Dębska, Marzena, Kretowicz, Piotr, Olędzka, Anna, Gastoł, Piotr, Dangel, Joanna, Świątkowska-Freund, Małgorzata, Dębski, Romuald
Format: Article
Language:English
Subjects:
Female
Fetal Diseases - diagnosis
Fetal Diseases - therapy
Fetuses
Humans
Patient Outcome Assessment
Pregnancy
Pregnancy Trimester, First
Premature birth
Prognosis
Stents
Ultrasonography, Prenatal
Urethral Obstruction - diagnosis
Urethral Obstruction - therapy
Urogenital system
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The aim of the study was to assess the outcome of vesico-amniotic shunting performed before 16 weeks of pregnancy in fetuses with severe megacystis diagnosed in the first trimester of pregnancy. Between January 2008 and October 2012 severe megacystis with the bladder length > 15 mm was diagnosed in 17 fetuses. The procedure of early vesico-amniotic shunting (VAS) was offered to 8 patients with presumably isolated LUTO. The procedure of VAS was performed in 6 fetuses. Before the intervention one or two procedures of vesicocentesis and urine analysis were performed. In all treated cases shunts provided urinary tract decompression. All babies were born prematurely, 2 of them died due to premaurity, 3 of them survived and have normal renal function at the age of 5-6 years. In 4/5 children accompanying malformations were later diagnosed, in 1 born prematurely neonate necropsy was not performed. Our results suggest that early vesico-amniotic shunting in fetal LUTO is feasible and may potentially prevent not only pulmonary hypoplasia but also renal insufficiency. However, the rationale of the procedure needs further investigation due to a high risk of long-term morbidity and co-existing malformations in children Before offering the therapy detailed counseling of the parents about the possible pros and cons of the therapy is necessary.
ISSN:0017-0011
2543-6767
DOI:10.5603/GP.a2017.0089