Management of prenatally diagnosed uropathies is controversial, mainly because the prognosis for these fetuses is quite different. However pioneering studies have shown that prenatal drainage of obstructed urinary tract can improve the outcome of selected fetuses. The aim of this study is to describe the experience of the Service with the treatment of fetal obstrutive uropathy with the catheter developed by the Centro de Medicina Fetal do Hospital das Clínicas da UFMG. A total of 25 fetuses with obstructive uropathy received the catheter. Three fetuses required more than one insertion. Ten of 25 (40%) shunted fetuses survived with good postnatal renal and pulmonary function. Complications occurred in 12/25 (48%) cases including: 06/25 (24%) inadequate shunt drainage or migration; 01/25 (04%) urinary ascitis; 01/25 (04%) DPP, 01/25 (04%) premature rupture of membranes, 02/25 (08%) premature labor, 01/25 (04%) scarring and fibrosis of the renal parenchyma. Three of 25 (12%) fetuses died intra-utero and 12 (48%) died during the neonatal period. In conclusion, the drainage of the obstructed urinary tract with this catheter proved to be technically feasible and safe for both mother and fetus, with a survival rate of 40%.
Obstructive uropathy; Fetal therapy; Fetal anomalies
