Photo Credit: Taras Dubov
The following is a summary of “Postnatal surgical complications in lower urinary tract obstruction following fetal vesico- amniotic shunting,” published in the February 2025 issue of BMC Pediatrics by Meßling et al.
Fetal lower urinary tract obstruction (LUTO) is a rare condition with high morbidity and mortality. Vesicoamniotic shunting (VAS) aims to preserve kidney function but poses risks like shunt dislocation and preterm premature rupture of membranes (PPROM).
Researchers conducted a retrospective study to assess postnatal complications of VAS.
They analyzed 25 fetuses who underwent VAS with a Somatex® shunt and postnatal removal at two fetal medicine centers. They assessed intrauterine course, pathology, postnatal outcome, shunt explantation details, and related complications. Data were retrospectively analyzed for intrauterine course, pathology, malformations, and perioperative characteristics, focusing on complications and interventions.
The results showed that 25 fetuses underwent VAS at a median of 17 weeks. About 2 newborns died within 24 hours due to fulminant lung hypoplasia. Shunt removal was done under local anesthesia in 10 (43%) newborns, while 13 (57%) required surgical explanation, including 5 (22%) complex cases.
Investigators found intrauterine VAS with a Somatex® shunt feasible, with most shunts easily removed after birth. However, complications like tissue damage, adhesions, and skin defects required early surgical management.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-025-05457-3
