Laser Ablation of Posterior Urethral Valves by Fetal Cystoscopy
| Autor: | Roland Devlieger, Esther Passchyn, Olga Gómez, Joan Rodo, Eduard Gratacós, Narcís Masoller, Jan Deprest, José María Martínez |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Embryology medicine.medical_specialty Urethral Obstruction Urinary Bladder Gestational Age Ultrasonography Prenatal Fetoscopy Urethra Pregnancy Urethral Diseases medicine Humans Radiology Nuclear Medicine and imaging Fetal Death Fetal therapy Fetus Laser ablation medicine.diagnostic_test business.industry Obstetrics and Gynecology Cystoscopy General Medicine Urethra surgery Surgery Fetal Diseases Pediatrics Perinatology and Child Health Female Laser Therapy Ultrasonography business Urethral valve |
| Zdroj: | Fetal Diagnosis and Therapy. 37:267-273 |
| ISSN: | 1421-9964 1015-3837 |
| Popis: | Objective: To report the results of fetal cystoscopic laser ablation of posterior urethral valves (PUV) in a consecutive series in two referral centers. Methods: Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by one or several firing-contacts with diode laser were attempted. Perinatal and long-term outcomes were prospectively recorded. Results: The median gestational age at procedure was 18.1 weeks (range 15.0-25.6), and median operation time was 24 min (range 15-40). Access to the urethra was achieved in 19/20 (95%) cases, and postoperative, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). Overall, there were 9 (45%) terminations of pregnancy and 11 women (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all were alive at 15-110 months. Eight (40% of all fetuses, 72.7% of newborns) had normal renal function and 3 (27.3%) had renal failure awaiting renal transplantation. Conclusion: Fetoscopic laser ablation for PUV can achieve bladder decompression and amniotic fluid normalization with a single procedure in selected cases with anyhydramnios. There is still a significant risk of progression to renal failure pre or postnatally. |
| Databáze: | OpenAIRE |
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