Fetoscopic transuterine release of posterior urethral valves: A new technique
Fetoscopic transuterine release of posterior urethral valves: A new technique
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DOI：
10.1159/000111585
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发表时间：
2008-01-01
影响因子：
2.2
通讯作者：
Lee, Hanmin
中科院分区：
文献类型：
--
作者：
Clifton, Matthew S.;Harrison, Michael R.;Lee, Hanmin
胎儿尿路梗阻伴羊水过少会导致肺发育不全和肾发育不良。梗阻尿路减压可以恢复羊水并促进肺部生长，但经腹导管分流减压通常不充分，并且不允许膀胱循环，而开放手术会导致严重的孕产妇发病率。破坏解剖学阻塞（通常是男性胎儿的后尿道瓣膜）是理想的选择，但事实证明在技术上很困难。在这里，我们描述了一种经皮胎儿膀胱镜检查和后尿道瓣膜破坏的新技术，以及我们首次应用该技术的病例报告。我们介绍了一例具有后尿道瓣膜的 17 周男性胎儿，该胎儿因后尿道瓣膜机械破坏而接受了胎儿膀胱镜检查。这种破坏胎儿后尿道瓣膜的微创方法是一种尿路减压的新方法。该技术可将孕产妇发病率降至最低，并且如果尽早实施，可以恢复羊水量，避免致命的肺发育不全，并可以保留肾功能。版权所有 (C) 2007 S. Karger AG，巴塞尔。
Fetal urinary tract obstruction with oligohydramnios produces pulmonary hypoplasia and renal dysplasia. Decompression of the obstructed urinary tract may restore amniotic fluid and allow lung growth, but transabdominal catheter shunt decompression is often inadequate and does not allow for cycling of the bladder, while open procedures cause significant maternal morbidity. Disruption of the anatomic obstruction, usually posterior urethral valves in a male fetus, would be ideal but has proven technically difficult. Here we describe a new technique of percutaneous fetal cystoscopy and disruption of posterior urethral valves, and the case report of our first application of this technique. We present a case of a 17-week male fetus with posterior urethral valves which underwent fetal cystoscopy for mechanical disruption of posterior urethral valves. This minimally invasive approach to disruption of posterior urethral valves in a fetus is a novel method for decompressing the urinary tract. The technique offers a minimal degree of maternal morbidity and, if instituted early enough, can restore amniotic fluid volume, avert fatal pulmonary hypoplasia and may preserve renal function. Copyright (C) 2007 S. Karger AG, Basel.