Long-Term Outcomes in Children Treated by Prenatal Vesicoamniotic Shunting for Lower Urinary Tract Obstruction

Biard, Jean–Marc; Johnson, Mark P.; Carr, Michael C.; Wilson, R. D.; Hedrick, Holly L.; Pavlock, Christina; Adzick, N. Scott

doi:10.1097/01.aog.0000171117.38929.eb

Cited by 203 publications

(126 citation statements)

References 22 publications

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“…The results seem promising. 6,7 But in developing countries the scenario is different. A substantial percentage of antenatal women especially from rural areas do not get antenatal check-ups and ultrasonography done and the anomaly in foetus goes undetected, as happened in our case.…”

Section: Discussionmentioning

confidence: 99%

Obstructed labour caused by rare congenital anomaly of foetus: managed by foetal abdominal tapping leading to successful vaginal delivery

Swaroop¹,

Sharma²,

Kumari³

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Obstructed labour caused by rare congenital anomaly of foetus: managed by foetal abdominal tapping leading to successful vaginal delivery

Swaroop¹,

Sharma²,

Kumari³

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…In another series, 17 of 34 patients survived vesicoamniotic shunting beyond 2 years of age; 13 patients died in the postnatal period, six of whom had pulmonary hypoplasia [32]. Biard et al [33] described a 1-year-survival of 91 % in a cohort of 18 fetuses who received vesicoamniotic shunting and found increased pulmonary survival as well as improved renal outcome. Nevertheless, 33 % were dependent on dialysis after birth, and 39 % retained pulmonary symptoms, mainly asthma [33].…”

Section: Treatment Options (Ante-and Postnatal)mentioning

confidence: 99%

Severe antenatally diagnosed renal disorders: background, prognosis and practical approach

Aulbert

Kemper

2015

Pediatr Nephrol

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“…Logo passaram a ser realizados em fetos humanos, porém os riscos eram muito altos em relação ao pequeno benefício de sobrevida em fetos com importante dano à função renal 52 . Ao longo dos anos, a abordagem aberta foi sendo substituída por técnicas endoscópicas ou percutâneas, com grande potencial para redução à morbidade das cirurgias tradicionais 54,55 .…”

Section: Iv) Intervenções Intrauterinas Em Casos De Obstrução Do Tratunclassified

Cirurgia fetal no contexto atual

Rocha

Filho

Bunduki

et al. 2018

Rev. Med. (São Paulo)

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RESUMO:A cirurgia fetal é, hoje, uma realidade em grandes centros especializados na área da medicina fetal. Surgiu por volta da década de 1960, inicialmente atrelada à necessidade de melhor conhecer e entender as patologias fetais, e teve desenvolvimento exponencial impulsionado pelo aprimoramento das técnicas diagnósticas pré-natais. Foi aos poucos se consolidando e tornando-se o tratamento de escolha para algumas patologias específicas, mudando definitivamente o curso dessas doenças. Nesse estudo, encontra-se um breve histórico das cirurgias fetais mais comumente realizadas em todo o mundo, como elas surgiram e como foram evoluindo com o passar do tempo, os principais estudos que as validaram e a técnica cirúrgica mais amplamente utilizada em cada caso. Entre as principais cirurgias, são citadas a fotocoagulação a laser de anastomoses placentárias na síndrome de transfusão feto-fetal, a correção intrauterina a céu aberto da mielomeningocele fetal e a oclusão endotraqueal fetal por balão nos casos de hérnia diafragmática congênita. Também são abordados cirurgias e procedimentos cujos benefícios são menos evidentes e os resultados ainda um tanto controversos, como as intervenções urinárias nos casos de obstrução ao trato urinário inferior, procedimentos cardíacos em casos de estenose aórtica crítica, derivações tóracoamnióticas para tratamento de derrames pleurais compressivos, além de ressecções intrauterinas de teratomas sacrococcígeos e de massas pulmonares. Também é feita uma avaliação a respeito do futuro da cirurgia fetal.Descritores: Feto/cirurgia; Fetoscopia. ABSTRACT:Fetal surgery is now a reality in large centers that specialize in the field of fetal medicine. Fetal surgery emerged in the 1960s, primarily from the need to better identify and understand fetal pathologies, and its exponential development was driven by improvements in prenatal diagnostic techniques. Fetal surgery gradually became the main treatment for specific fetal pathologies, changing the course of these diseases. This study summarizes the history of the fetal surgeries that are most commonly performed worldwide, how they started and how they evolved over time, the main validation trials and the most widely used surgical technique in each case. The main surgeries include laser photocoagulation of placental anastomoses in twin-to-twin transfusion syndrome, in utero repair of fetal myelomeningocele and fetal endotracheal occlusion in cases of congenital diaphragmatic hernia. Other surgeries and procedures, whose benefits are less clear and whose results are still somewhat controversial, such as urinary interventions in cases of lower urinary tract obstruction, cardiac procedures in cases of critical aortic stenosis, thoracoamniotic shunts for the treatment of massive pleural effusions and intrauterine resection of sacrococcygeal teratomas and pulmonary masses, are also cited. The future of fetal surgery is also assessed.

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Long-Term Outcomes in Children Treated by Prenatal Vesicoamniotic Shunting for Lower Urinary Tract Obstruction

Abstract: III.

Cited by 203 publications

References 22 publications

Obstructed labour caused by rare congenital anomaly of foetus: managed by foetal abdominal tapping leading to successful vaginal delivery

Obstructed labour caused by rare congenital anomaly of foetus: managed by foetal abdominal tapping leading to successful vaginal delivery

Severe antenatally diagnosed renal disorders: background, prognosis and practical approach

Cirurgia fetal no contexto atual

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