| In utero management of fetal lower urinary tract obstruction with a novel shunt: a landmark development in fetal therapy. | |
| | |
MedLine Citation:
|
PMID: 19968590 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Fetal lower urinary tract obstruction occurs in approximately 1:3000 pregnancies. Standard vesicoamniotic shunting is fraught with malfunctioning in upto 60% of cases. We hereby report the development and application of a novel and reliable shunt. MATERIALS AND METHODS: Patients with lower urinary tract obstruction were offered the novel shunt among other standard management options. Shunting involved the placement of a double disk device with a standard double pig-tail catheter. All patients signed informed consent. RESULTS: Four patients have been treated with the novel shunt. In three patients, shunting was conducted between the bladder and amniotic cavity. In one patient (dichorionic-discordant twins) with a prior dislodged shunt causing urinary ascites, shunting was conducted between the peritoneal and amniotic cavities ('bridge shunt'). In all cases, correct and stable shunt placement was confirmed endoscopically and sonographically and in all patients, the fetal bladder remains effectively drained. CONCLUSION: Reliable and effective vesico or peritoneoamniotic shunting can be achieved with the novel shunt. This shunt cannot become dislodged into the peritoneal cavity or the amniotic cavity, and cannot be pulled out by the fetus. Further experience is necessary to determine the risks and benefits of this novel treatment for fetal lower urinary tract obstruction. |
| | |
Authors:
|
Ruben A Quintero; Libardo Augusto Gomez Castro; Carlos Bermudez; Ramen H Chmait; Eftichia V Kontopoulos |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Volume: 23 ISSN: 1476-4954 ISO Abbreviation: J. Matern. Fetal. Neonatal. Med. Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-07-16 Completed Date: 2010-11-04 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: England |
Other Details:
|
Languages: eng Pagination: 806-12 Citation Subset: IM |
Affiliation:
|
Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. rquintero@med.miami.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Female Fetal Diseases / surgery* Fetal Therapies Humans Male Pregnancy Urethral Obstruction / surgery* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Review of vaginal birth after primary caesarean section without prostaglandin induction and or synto...
Next Document: First trimester abnormal profile and facial angle. Early features of anterior cephalocele.