태아 수흉, 복수와 폐쇄성 요로병증을 위한 자궁내 단락술 : 7예 검토

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.