Perinatal Outcomes of Fetal Lower Urinary Tract Obstruction After Vesicoamniotic Shunting Using a Double-Basket Catheter

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
Ba-Da JeongMi-Young Lee

Abstract

To evaluate the perinatal survival and renal function of fetuses with lower urinary tract obstruction (LUTO) who underwent vesicoamniotic shunting using a double-basket catheter METHODS: We retrospectively reviewed 32 fetuses with LUTO who underwent vesicoamniotic shunting using a double-basket catheter between 1998 and 2013. Among the 32 fetuses examined, 5 died because of termination of pregnancy, and 2 died in utero. The median gestational age at diagnosis was 15.5 (range, 10.0-27.3) weeks, and that at initial shunting was 17.1 (range, 12.3-32.2) weeks. Shunt dislocation or occlusion occurred in 18 of 42 procedures (42.8%). The median gestational age at delivery for the 25 live births was 35.5 (range, 28-40) weeks. Postnatal diagnosis revealed posterior urethral valves in 15 fetuses, a cloacal anomaly in 7, and urethral stenosis in 3. Three neonatal deaths occurred, resulting in an overall perinatal survival rate of 68.8% (22 of 32). The rates of normal renal function were 40.6% (13 of 32) at 28 days and 40% (10 of 25) at 2 years after birth. The absence of oligohydramnios after shunting was the only prognostic factor for normal renal function at 2 years (P < .05). Vesicoamniotic shunting may be helpful for fetuses with LUTO.

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Citations

May 18, 2019·Biomaterials Science·Sally M WinklerPhillip B Messersmith
Apr 20, 2019·Frontiers in Pediatrics·Beatiz Bañuelos MarcoAnja Lingnau
Jun 15, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Chryso Pefkaros Katsoufis
Oct 6, 2020·Global Pediatric Health·Lisa B E ShieldsEran Rosenberg

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