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Re: 20 wk IUP, megacystis, anhydramnios, gender unknown From: Lynn Montgomery (lmontgomery@communitymed.org) Thu Mar 23 09:17:09 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Geffrey Klein, MD: "herpes" Previous message: Terry Burrell: "Infant Security and tracking systems" Maybe in reply to: dr. peterman: "20 wk IUP, megacystis, anhydramnios, gender unknown" Next in thread: Joe Cutchin: "Re: 20 wk IUP, megacystis, anhydramnios, gender unknown" With the findings you describe, I would consider a shunt placement. Prior to that though, I would attempt to get a better look at the fetus via amnioinfusion. This will assure that you don't have other fetal problems. The amnioinfusion will also make the shunt placement much easier. Used to use a Rocket system for the shunt placement. For that you had to have the instruments, etc. Cook now makes a great shunt system that is all self contained, single use. The shunt is just a small double pig-tail catheter. Even though it sounds like a big deal, with the Cook system, it is very much like an amnio only a little larger needle. At the time of the catheter placement, you can get a urine specimen for lytes, etc. At 20 weeks this may not be very helpful. Further, if the kidneys are not hydronephrotic at this point then it is unlikely that there is renal damage yet. Lynn -- Lynn D. Montgomery, M.D. Director, Maternal-Fetal Medicine Rocky Mountain Perinatal Center 2825 Fort Missoula Road, Suite 130 Missoula, Montana, 59804 406-327-4094 fax 406-327-4154 e-mail: lmontgomery@communitymed.org website: http://www.communitymed.org/rmpc/ -----Original Message----- From: dr. peterman <peterman@proteus.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> Date: Wednesday, March 22, 2000 7:04 PM Subject: 20 wk IUP, megacystis, anhydramnios, gender unknown >25 y/o WF G1P0 with class B diabetes and a 20 week sonogram that shows >anhydramnios and megacystis suggesting urethral level obstruction. >Sonogram does not reveal the fetus' gender. Single kidney identified. >Ureters not dilated, but image quality poor due to anhyramnios. What is >the standard of care for this patient? Does in utero urinary tract >diversion have a role in her care? How is in utero urinary tract >diversion performed? What role does serial fetal urinalyses have in >deciding her candidacy for diversion? > >p.peterman. > Next message: Geffrey Klein, MD: "herpes" Previous message: Terry Burrell: "Infant Security and tracking systems" Maybe in reply to: dr. peterman: "20 wk IUP, megacystis, anhydramnios, gender unknown" Next in thread: Joe Cutchin: "Re: 20 wk IUP, megacystis, anhydramnios, gender unknown"

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