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Intrauterine vesicoamniotic shunting for fetal megacystis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To examine the outcome of fetuses with megacystis treated with vesicoamniotic shunting (VAS) from 14 weeks onward.

Methods

Retrospective review of all fetuses that received VAS at two centres from 2004 to 2012.

Results

53 fetuses with megacystis were included in the study. Mean gestational age at diagnosis was 16.4 weeks. Mean gestational age at first shunt placement was 17.8 weeks. The first shunt placement was performed before 16 weeks in 18 (34 %) cases. The mean number of shunts was 1.38. Dislocation occurred in 35 (66 %). TOP was performed in 21 (39.6 %), intrauterine death occurred in two (3.8 %) and spontaneous abortion in three cases (5.7 %). Of the 27 (50.9 %) live births, 17 (32.1 %) infants survived. Normal renal function was present in 10 cases, 4 have compensated renal failure and 3 infants had renal transplantation. Oligohydramnios was significantly associated with non-survival and renal insufficiency. The gestational age at VAS was neither correlated with renal function after birth nor with the survival in our cohort. Conversely, the interval between first shunt placement and delivery was positively correlated with survival and normal renal function. The gestational age at delivery was significantly higher in survivors and those born with normal renal function.

Conclusion

Despite intervention, the morbidity and mortality of megacystis is still high. We failed to demonstrate that early intervention is associated with an improved rate of normal renal function after birth. Oligohydramnios was the only parameter identifying fetuses with unfavourable outcome, while all other parameters were inconclusive.

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Authors and Affiliations

  1. Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

    R. Stadié, B. Strizek, A. Geipel, U. Gembruch & C. Berg

  2. Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Kerpenerstr. 34, 50931, Köln, Germany

    I. Gottschalk & C. Berg

Authors
  1. R. Stadié
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  2. B. Strizek
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  3. I. Gottschalk
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  4. A. Geipel
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  5. U. Gembruch
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  6. C. Berg
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Corresponding author

Correspondence to C. Berg.

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Funding

This study was not funded.

Conflict of interest

R. Stadié declares that she has no conflict of interest. B. Strizek declares that she has no conflict of interest. I. Gottschalk declares that he has no conflict of interest. A. Geipel declares that she has no conflict of interest. U. Gembruch declares that he has no conflict of interest. C. Berg declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. It is a retrospective archive study. The institutional review boards of the universities of Bonn and Cologne do not require formal approval for retrospective archive studies; therefore, an ethical approval was not sought.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Stadié, R., Strizek, B., Gottschalk, I. et al. Intrauterine vesicoamniotic shunting for fetal megacystis. Arch Gynecol Obstet 294, 1175–1182 (2016). https://doi.org/10.1007/s00404-016-4152-4

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  • DOI: https://doi.org/10.1007/s00404-016-4152-4

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