In Utero Shunting for Fetal Hydrothorax, Ascites and Obstructive Uropathy: A Review of 7 Cases / 대한주산의학회잡지

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.