Korean J Perinatol.
2004 Dec;15(4):379-387.
In Utero Shunting for Fetal Hydrothorax, Ascites and Obstructive Uropathy: A Review of 7 Cases
- Affiliations
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- 1Perinatal Center, Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. dr3431@yumc.yonsei.ac.kr
- 2Pediatrics, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- 3Urology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- 4Department of Obstetrics and Gynecology, Ajou University College of Medicine, Suwon, Korea.
- 5Department of Obstetrics and Gynecology, Gachon Medical School, Incheon, Korea.
- 6Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- 7Surgery, Yonsei University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE
To evaluate the value of intrauterine shunting and to investigate the complication and outcome of these procedures for different fetal indications.
METHODS
7 fetuses who underwent 13 intrauterine catheter shunting from 1992 to 1997 were reviwed. The indications were uni-or bilateral hydrothorax in 4 cases, ascites in one case, and obstructive uropathy in 2 cases.
RESULTS
Catheter migration occurred 6 times out of the 13 shunts (46%). Procedure related death rate was 23% (3/13); within 48 hours of pleuroamniotic shunting, amniorrhexis and coincidental abruptio placenta resulting in one fetal death and each one of amniorrhexis and premature labor resulting in 2 neonatal deaths. Pregnancy was terminated after shunting in one case of urethral atresia. Postnatal survival rate was 50% (3/6).
CONCLUSION
A high complication rate requires the selection of cases for shunting. A large prospective controlled trial is needed to determine its value.
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