LEADING ARTICLE
Fetal bladder shunting
Vesicoamniotic shunting for fetal lower urinary tract obstruction: an overview
Division of Reproductive and Child Health, Birmingham Women’s Hospital, University of Birmingham, Birmingham, B15 2TG, UK
Correspondence to:
Correspondence to:
Dr M D Kilby
Department of Fetal Medicine, Division of Reproductive and Child Health, Birmingham Women’s Hospital, University of Birmingham, Birmingham B15 2TG, UK; m.d.kilby@bham.ac.uk
Accepted 13 September 2006
Efficacy and complications of prenatal in utero treatment
| The first 150 words of the full text of this article appear below. |
Lower urinary tract obstruction (LUTO) is a heterogeneous group of pathologies, most commonly urethral atresia and posterior urethral valves (PUVs)1 that accounts for one third of renal tract anomalies detected at autopsy after termination for ultrasound-diagnosed fetal anomaly.2 The affected fetus is typically male unless associated with bladder hypoperistalsis syndromes which carry a worse prognosis. PUV accounts for about half of the cases presenting with ultrasonic features of LUTO3 in some case cohorts. In 2005, data from the Northern Region Congenital Anomaly register were reported. Over a 14-year period, 113 cases of LUTO were identified, giving an incidence of 2.2 in 10 000 births.4
The importance of LUTO in terms of perinatal outcome lies in its clinical course, with long-term urethral obstruction being potentially associated with cystic renal dysplasia, abnormal renal (glomerular and tubular) function leading to severe oligohydramnios, pulmonary hypoplasia and positional limb anomalies.5 Animal studies
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