Fetal Cystoscopy for Severe Lower Urinary Tract Obstruction (LUTO): A Prospective Trial
The purpose of the study is to study the outcomes of maternal and fetal patients who are undergoing fetal intervention for severe isolated lower urinary tract obstruction (LUTO).
• Pregnant women
• Singleton pregnancy
• Maternal age ≥ 18 years
• Male fetus with LUTO, dilated bladder, keyhole sign and bilateral hydronephrosis
• Oligohydramnios or Anhydramnios
• Favorable urine analysis defined as urinary sodium is \< 100 milliequivalents per liter (mEq/L), chloride \< 90 mEq/L, and osmolality \< 200 milliosmoles per kilogram (mOsm/kg) after 20 weeks and in the absence of previous in utero intervention for the disease (vesicoamniotic shunt placement or fetal cystoscopy).
• Absence of chromosomal abnormalities and associated anomalies
• Gestational age at the time of the procedure will be between 16 0/7 weeks and 25 6/7 weeks
• Normal karyotype by invasive testing (amniocentesis or Chorionic Villus Sampling (CVS)). Patients declining invasive testing will be excluded.
⁃ Family have considered and declined the option of termination of the pregnancy at less than 24 weeks.
⁃ Family meets psychosocial criteria, including sufficient social support and ability to understand requirements of the study.
⁃ Parents or guardian are willing to provide signed informed consent.