Gynäkologie und Geburtshilfe
Offener Zugang

Abstrakt

Prenatal Diagnosis of Severe Fetal Renal Pelvic Dilatation and Treatment with Double Pig Tail Catheter

Ricardo J Hernandez H, Mauro Alberto Ochoa Torres and Rene Ramos Gonzalez

Introduction: Fetal urinary tract obstructions require feto-amniotic shunting with percutaneous vesico centesis or Double Pig Tail Catheter (DPTC) draining fetal urine to the amnion, mainly used to treat low urinary tract obstructions and though is associated to high morbidity; if it is early applied maintains permeable the urinary tract, prolongs fetal life and prevents maternal complications. There are few fetal patients with upper urinary tract obstructions treated by DPTC reported. We report a fetal patient with severe upper urinary obstruction due to ureteric-pelvic stenosis, derived to amnion with a DPTC.

Case: A 19 years old women with 30 weeks of gestation was sent with diagnosis of an abdominal giant cystic in the fetus. The Ultrasound (US) confirmed the presence of a cystic abdominal mass of 10 cm by 10 cm, associated to left renal dilatation, the right kidney was ectopic and dilated forming the cystic mass secondary to an upper urinary tract obstruction, the bladder was normal displaced to the left. An US guided insertion of a DPTC was successfully done at 32 weeks of gestation. The pregnancy ended at 37 weeks with a 2,600 g female newborn, without abdominal cyst and normal creatinine. A follow up by the Pediatric Surgical Department until 18 months old observed normal serum creatinine levels.

Conclusion: A successful installation of a DPTC in a 32 weeks of gestation fetus released a severe upper urinary tract obstruction maintaining permeable after borne.