Guidelines for Vesicoamniotic Shunting
Inclusion criteria
- Identification of an isolated lower urinary tract obstruction in a male fetus
- Singleton pregnancy
- Normal male karyotype (normal male FISH results might be acceptable in specific circumstances)
- Presence of oligohydramnios (AFV
- Gestational age >16wks and
- Serial vesicocentesis data indicate renal function in the good prognosis range as outlined below
Good prognosis (as measured at gestational age 18-22 weeks):
- Sodium
- Cloride
- Osmolality
- Total protein
- Beta 2 microglobulin
- Calcium
Poor prognosis (as measured at gestational age 18-22 weeks):
- Sodium >100 mmol/L
- Cloride >90 mmol/L
- Osmolality >200 mOsm/L
- Total protein >40 mg/dl
- Beta 2 microglobulin >10 mg/L
- Calcium >8 mg/dl
*Wu and Johnson, Clin Perinatol 36(2009), p.377-390
Exclusion criteria
- Multi-fetal pregnancy
- Presence of additional major anomalies unrelated to lower urinary tract obstruction
- Evidence of fibrocystic renal dysplasia
- Normal amniotic fluid volume
- Serial vesicocentesis data indicating renal electrolytes in the poor prognosis range as outlined above
- Maternal contraindications
Find more professional resources for managing complex genitourinary anomalies.
Contact the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment
Appointments & referrals (800-IN-UTERO)