First Trimester Diagnosis and Early in Utero Treatment of Obstructive Uropathy

Drugan, Arie; Zador, Ivan E.; Bhatia, Rupinder K.; Sacks, Alan J.; Evans, Mark I.

doi:10.3109/00016348909013286

Cited by 19 publications

(12 citation statements)

References 10 publications

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“…This is supported by previous studies involving 31 cases of fetal megacystis ( Table 1) which showed that in five of seven cases treated by bladder drainage between 10 and 14 weeks, the postnatal renal function was normal in four and reduced to 50% in one 2,6,7,8 . In a …”

Section: Discussionsupporting

confidence: 77%

Vesicocentesis at 10–14 weeks of gestation for treatment of fetal megacystis

Carroll

Soothill

Tizard

et al. 2001

Ultrasound in Obstet & Gyne

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Section: Discussionsupporting

confidence: 77%

Vesicocentesis at 10–14 weeks of gestation for treatment of fetal megacystis

Carroll

Soothill

Tizard

et al. 2001

Ultrasound in Obstet & Gyne

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“…However, there are a few published case reports of children with LUTO that were subjected to early vesico-amniotic shunting and survived until birth with normal renal function what raises the question of the benefit of an earlier treatment [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

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

Dębska¹,

Kretowicz²,

Olędzka³

et al. 2017

Ginekol Pol

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Objectives: 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. Material and methods: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. Results: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. Conclusions: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.

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“…Au moment du diagnostic, la moyenne d'âge maternel était de 31 ans (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) La moyenne du diamètre longitudinal de la vessie au moment du diagnostic était de 20 mm .…”

Section: Résultatsunclassified