Outcomes of fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt: A single-institution experience

Ethun, Cecilia G.; Zamora, Irving J.; Roth, David R.; Kale, Arundhati S.; Cisek, Lawrence J; Belfort, Michael A.; Haeri, Sina; Ruano, Rodrigo; Welty, Stephen E.; Cassady, Christopher I.; Cass, Darrell L.

doi:10.1016/j.jpedsurg.2013.02.011

Cited by 33 publications

(31 citation statements)

References 33 publications

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“…In the Kaplan-Meier curve analysis foetuses with at least 2 increased classical biochemical parameters (osmolarity, sodium and chloride concentration) had lower survival rate. These results are concordant with other studies, where only combined prenatal factors were potentially qualified as significant in multivariate analysis [5,14,18,19].…”

Section: Discussionsupporting

confidence: 92%

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Neonatal survival and kidney function after prenatal interventions for obstructive uropathies

et al. 2019

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Objectives: Prenatal interventions in LUTO (lower urinary tract obstruction) usually are still question of a debate between gynaecologist and paediatric nephrologist. We aimed the study to assess the early survival rate and renal outcome in LUTO foetuses. Material and methods: The study was a prospective data analysis of 39 foetuses from singleton pregnancies. All pregnant women with LUTO in the foetus were qualified for VAS based on a local practice. The mean time of first urine analysis ranged between 13-30 weeks of pregnancy. Primary end-point analysis included live birth, 28d-survival, pulmonary and renal function assessment in neonatal period. Results: From initial number of 39, six patients miscarried before the procedure was performed. Overall, 33 VAS were performed at the mean 21 week of pregnancy (range 14-30 weeks). 25/39 foetuses survived until delivery. Three neonates died in first 3 days of life. In the first month 3 children required peritoneal dialysis, but at 28 day all children were dialysis-free. Overall survival rate at 28 day was 56%. Renal function preservation of the initial group (39) turned out to be low-18% (7/39). Conclusions: Our study showed average survival curves and complications. LUTO in the foetus had mostly unfavourable outcome in the neonatal period. The prenatal intervention did not increase it significantly and did not guarantee the preservation of normal kidney function.

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Section: Discussionsupporting

confidence: 92%

“…Ethun et al [14] analysed outcome of 14 patients after prenatal intervention of LUTO and showed similar results to our observation with regard to success and complications. Jeong et al [15] showed among the 32 foetuses examined that: 5 died because of termination of pregnancy, and 2 died in utero.…”

Section: Discussionsupporting

confidence: 88%

Neonatal survival and kidney function after prenatal interventions for obstructive uropathies

et al. 2019

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“…The poor outcomes in these cases in our unit may be due to lack of experience in performing vesicocentesis and vesicoamniotic shunts (VAS). Ethun et al [15] reported their experience in the management of 14 fetuses with megacystis, of whom 11 underwent intervention. One patient received vesicocentesis alone, while 10 had VAS.…”

Section: Discussionmentioning

confidence: 99%

Types and Outcome of Fetal Urinary Anomalies in Low Resource Setting Countries: A Retrospective Study

Shalaby

Hemida

Nabil

et al. 2015

J Obstet Gynecol India

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“…LUTO accounts for 15% to 20% of pediatric end stage renal failure115 as well as 10% to 60% of pediatric renal transplantations 111. Mortality rates vary but can be as high as 80% to 90% 114116…”

Section: Fetal Endoscopic Surgeriesmentioning

confidence: 99%

Prenatal regenerative fetoscopic interventions for congenital anomalies

Ruano

2020

BMJ

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Abstract Fetal intervention has progressed in the past two decades from experimental proof-of-concept to practice-adopted, life saving interventions in human fetuses with congenital anomalies. This progress is informed by advances in innovative research, prenatal diagnosis, and fetal surgical techniques. Invasive open hysterotomy, associated with notable maternal-fetal risks, is steadily replaced by less invasive fetoscopic alternatives. A better understanding of the natural history and pathophysiology of congenital diseases has advanced the prenatal regenerative paradigm. By altering the natural course of disease through regrowth or redevelopment of malformed fetal organs, prenatal regenerative medicine has transformed maternal-fetal care. This review discusses the uses of regenerative medicine in the prenatal diagnosis and management of three congenital diseases: congenital diaphragmatic hernia, lower urinary tract obstruction, and spina bifida.

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Outcomes of fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt: A single-institution experience

Cited by 33 publications

References 33 publications

Neonatal survival and kidney function after prenatal interventions for obstructive uropathies

Neonatal survival and kidney function after prenatal interventions for obstructive uropathies

Types and Outcome of Fetal Urinary Anomalies in Low Resource Setting Countries: A Retrospective Study

Prenatal regenerative fetoscopic interventions for congenital anomalies

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