Antenatal treatment of fetal urinary tract malformations. Apropos of the treatment of a case of posterior urethral valves
Fournié, A.; Sarramon, M.F.; Rolland, M.; Moscovici, J.; Galissier, J.C.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 12(6): 649-656
1983
ISSN/ISBN: 0368-2315 PMID: 6655225 Document Number: 213178
Palliative in utero treatments of certain malformations of the fetal urinary tract are now possible. The most important of these is urethral obstruction by valves. A case of in utero treatment of such a disease is reported, with a six month follow-up of the infant. In utero diversion of urine was performed by means of a catheter placed in the bladder using a technique derived from intra-uterine transfusions. The purpose is to permit drainage of urine from the kidneys into the liquor to prevent permanent damage to the kidneys because of back pressure. The technical problems included deciding the correct size of catheter and the technique of localising the bladder and inserting the catheter under ultrasound control. The ethical problems are raised partly because there is no central ethical committee to make decisions and partly because of the need to evaluate and to inform the patients of the various risks. The patients take the risk on behalf of their children and the mother takes a small risk for her own health.