Universität zu Köln

Stadie, R., Strizek, B., Gottschalk, I., Geipel, A., Gembruch, U. and Berg, C. (2016). Intrauterine vesicoamniotic shunting for fetal megacystis. Arch. Gynecol. Obstet., 294 (6). S. 1175 - 1183. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-0711

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Abstract

To examine the outcome of fetuses with megacystis treated with vesicoamniotic shunting (VAS) from 14 weeks onward. Retrospective review of all fetuses that received VAS at two centres from 2004 to 2012. 53 fetuses with megacystis were included in the study. Mean gestational age at diagnosis was 16.4 weeks. Mean gestational age at first shunt placement was 17.8 weeks. The first shunt placement was performed before 16 weeks in 18 (34 %) cases. The mean number of shunts was 1.38. Dislocation occurred in 35 (66 %). TOP was performed in 21 (39.6 %), intrauterine death occurred in two (3.8 %) and spontaneous abortion in three cases (5.7 %). Of the 27 (50.9 %) live births, 17 (32.1 %) infants survived. Normal renal function was present in 10 cases, 4 have compensated renal failure and 3 infants had renal transplantation. Oligohydramnios was significantly associated with non-survival and renal insufficiency. The gestational age at VAS was neither correlated with renal function after birth nor with the survival in our cohort. Conversely, the interval between first shunt placement and delivery was positively correlated with survival and normal renal function. The gestational age at delivery was significantly higher in survivors and those born with normal renal function. Despite intervention, the morbidity and mortality of megacystis is still high. We failed to demonstrate that early intervention is associated with an improved rate of normal renal function after birth. Oligohydramnios was the only parameter identifying fetuses with unfavourable outcome, while all other parameters were inconclusive.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stadie, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Strizek, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gottschalk, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Geipel, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gembruch, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berg, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-257234
DOI:	10.1007/s00404-016-4152-4
Journal or Publication Title:	Arch. Gynecol. Obstet.
Volume:	294
Number:	6
Page Range:	S. 1175 - 1183
Date:	2016
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-0711
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language URINARY-TRACT OBSTRUCTION; POSTNATAL RENAL-FUNCTION; DIAGNOSIS; EXPERIENCE; MANAGEMENT; ACCURACY; OUTCOMES; FETUSES Multiple languages Obstetrics & Gynecology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25723