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The effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review.
MedLine Citation:
PMID:  21374748     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis and intervention for congenital lower urinary tract obstruction. METHODS: Literature search using Medline, Embase, Cochrane Library, MEDION, Web of Science reference lists, and contact with experts. All studies reporting on fetal cystoscopy in lower urinary tract obstruction with data for a 2×2 table were selected for review. No language restrictions were applied. There was independent selection of studies, data extraction, and quality assessment by two reviewers. Peto odds ratios were calculated as a summary measure of effect. MAIN RESULTS: A total of 2071 citations were identified, 66 papers selected for detailed evaluation. Four papers were selected for inclusion including a total of 63 patients. Two papers had results for use of cytsoscopy for diagnosis. Fetal cystoscopy altered the ultrasound diagnosis of underlying pathology in 36.4% and 25% of fetuses in each paper. Compared to no treatment, fetal cystoscopic intervention demonstrated an odds ratio for improved perinatal survival of 20.51 (95% CI 3.87,106.89). However, comparing VAS to fetal cystoscopy there appeared to be no significant improvement in perinatal survival odds ratio 1.49 (0.13,16.97). These results had wide confidence intervals and for cystoscopy versus VAS, all results crossed the line of no effect. CONCLUSIONS: There is little published evidence for the effectiveness of therapeutic fetal cystoscopy as an intervention for congenital lower urinary tract obstruction and the quality of this evidence is poor. It should thus be considered to be an 'experimental intervention' and subject to further investigation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
R Katie Morris; Rodrigo Ruano; Mark D Kilby
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-3
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
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