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CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2023; 10(04): 175-181
DOI: 10.1055/s-0044-1782222
SFM Practice Guidelines

SFM Fetal Therapy Practice Guidelines: Fetal Cystoscopic Laser Ablation

Gourisankar Rudrapal
1   Division of Fetal Medicine & Perinatology, Department of Obstetrics & Gynecology, Amrita Institute of Medical Sciences, AIMS Ponekkara, Kochi, Kerala, India
,
Adinarayan Makkam
1   Division of Fetal Medicine & Perinatology, Department of Obstetrics & Gynecology, Amrita Institute of Medical Sciences, AIMS Ponekkara, Kochi, Kerala, India
,
Vivek Krishnan 
1   Division of Fetal Medicine & Perinatology, Department of Obstetrics & Gynecology, Amrita Institute of Medical Sciences, AIMS Ponekkara, Kochi, Kerala, India
› Author Affiliations Funding None.
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Abstract

Fetal lower urinary tract obstruction (LUTO) in a male fetus could cause detrimental effects to the KUB (kidney, ureter, and bladder) system from back-pressure changes as well as to the lungs from reduced amniotic fluid. In a carefully selected case where the obstruction causes progressive damage, a therapeutic intervention could be lifesaving. In utero vesico-amniotic shunting has been shown to improve perinatal pulmonary survival, but evidence on improvement of renal outcomes with this procedure is lacking. More recently, fetal cystoscopic laser fulguration has been shown to be beneficial in longer-term survival and renal outcomes. These interventions carry significant risk, and therefore patient selection and optimal timing are key. This guideline lists the intricacies of patient selection, relevant counseling points and procedural details.

Keywords

LUTO - PUV - fetal cystoscopy - laser fulguration


Publication History

Article published online:
01 April 2024

© 2024. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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