Therapeutic intervention for lower urinary tract obstruction in the fetus: current evidence and future strategies

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Therapeutic intervention for lower urinary tract obstruction in the fetus : current evidence and future strategies. / Farrugia, Marie-Klaire; Kilby, Mark.

In: Journal of Pediatric Urology, 31.01.2021.

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@article{aa2faea9af4e4f8f8f193bc56093e365,
title = "Therapeutic intervention for lower urinary tract obstruction in the fetus: current evidence and future strategies",
abstract = "In-utero vesica-amniotic shunting for fetal lower urinary obstruction (LUTO) is known to improve perinatal survival. More recently, studies including centres performing fetal cystoscopy, have suggested benefit on longer-term survival and renal outcome – within the limitations of small numbers and limited follow-up. These interventions carry significant risk, and therefore patient selection, and optimal timing, are key. The aim of this article is to explore ways of improving the accuracy of prenatal diagnosis, and of identifying risk factors for fetal and postnatal renal failure. The next step is that of using established staging and classification systems to select the patient group that may benefit from intervention, based on published outcomes. Several factors come into play when selecting the timing of intervention, especially if the aim is that of renal, and not only pulmonary, preservation. Lastly, current technologies and their shortfalls are discussed.",
keywords = "Fetal, Lower urinary tract obstruction, Bladder outflow obstruction, Renal failure, Cystoscopy, Antenatal",
author = "Marie-Klaire Farrugia and Mark Kilby",
year = "2021",
month = jan,
day = "31",
doi = "10.1016/j.jpurol.2021.01.034",
language = "English",
journal = "Journal of Pediatric Urology",
issn = "1477-5131",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Therapeutic intervention for lower urinary tract obstruction in the fetus

T2 - current evidence and future strategies

AU - Farrugia, Marie-Klaire

AU - Kilby, Mark

PY - 2021/1/31

Y1 - 2021/1/31

N2 - In-utero vesica-amniotic shunting for fetal lower urinary obstruction (LUTO) is known to improve perinatal survival. More recently, studies including centres performing fetal cystoscopy, have suggested benefit on longer-term survival and renal outcome – within the limitations of small numbers and limited follow-up. These interventions carry significant risk, and therefore patient selection, and optimal timing, are key. The aim of this article is to explore ways of improving the accuracy of prenatal diagnosis, and of identifying risk factors for fetal and postnatal renal failure. The next step is that of using established staging and classification systems to select the patient group that may benefit from intervention, based on published outcomes. Several factors come into play when selecting the timing of intervention, especially if the aim is that of renal, and not only pulmonary, preservation. Lastly, current technologies and their shortfalls are discussed.

AB - In-utero vesica-amniotic shunting for fetal lower urinary obstruction (LUTO) is known to improve perinatal survival. More recently, studies including centres performing fetal cystoscopy, have suggested benefit on longer-term survival and renal outcome – within the limitations of small numbers and limited follow-up. These interventions carry significant risk, and therefore patient selection, and optimal timing, are key. The aim of this article is to explore ways of improving the accuracy of prenatal diagnosis, and of identifying risk factors for fetal and postnatal renal failure. The next step is that of using established staging and classification systems to select the patient group that may benefit from intervention, based on published outcomes. Several factors come into play when selecting the timing of intervention, especially if the aim is that of renal, and not only pulmonary, preservation. Lastly, current technologies and their shortfalls are discussed.

KW - Fetal

KW - Lower urinary tract obstruction

KW - Bladder outflow obstruction

KW - Renal failure

KW - Cystoscopy

KW - Antenatal

U2 - 10.1016/j.jpurol.2021.01.034

DO - 10.1016/j.jpurol.2021.01.034

M3 - Article

JO - Journal of Pediatric Urology

JF - Journal of Pediatric Urology

SN - 1477-5131

ER -