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KMID : 0361720040150040379
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Korean Journal of perinatology
2004 Volume.15 No. 4 p.379 ~ p.387
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Original Reports : In Utero Shunting for Fetal Hydrothorax, Ascites and Obstructive Uropathy: A Review of 7 Cases
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Lee Kook
Lee Byung-Seok
Choi Seung-Hoon
Park Min-Soo
Lee Chul
Kim Suk-Young
Yang Jeong-In
Choi Seung-Kang
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Abstract
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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.
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KEYWORD
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In utero shunting, Hydrothorax, Ascites, Obstructive uropathy, Fetus
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