Fetal vesico-amniotic shunting procedure (VASP) for posterior urethral valve syndrome at 19weeks' gestation / 대한산부인과학회잡지

ABSTRACT

An ultrasonographic examination revealed increased fetal bladder size and decreased AFI as well as fetal bilateral hydronephrosis at 173weeks' gestation. Diagnosis of the fetal posterior urethral valve syndrome was made. Percutaneous fetal bladder puncture with aspiration and amniocentesis was performed. The fetus was normal male karyotype and with a predicted good renal function(sodium concentration, chloride concentration, and osmolarity at 74 mEq/L, 60 mEq/L, and 148 mOsm, respectively). So, the fetus underwent amnioinfusion and vesico-amniotic shunting procedure (VASP) using a double-basket catheter at 194weeks' gestation in order to prevent development of dysplastic kidneys and hypoplastic lungs. The healthy male baby was delivered at 384weeks' gestation and had normally functioning kidney. Cutaneous vesicostomy was performed for the newborn since the urethral orifice was small. The one year old infant is now well and waiting for urethroscopic valve ablation procedure.