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Early fetal cystoscopy for first-trimester severe megacystis.
[megacystis-microcolon-intestinal hypoperistalsis syndrome]
To
report
the
feasibility
of
early
fetal
cystoscopy
for
the
prenatal
diagnosis
and
therapy
of
severe
first
-trimester
megacystis
.
Between
January
2008
and
February
2010
,
early
fetal
cystoscopy
at
16
weeks
of
gestation
was
offered
to
15
patients
whose
fetuses
presented
with
severe
first
-trimester
megacystis
.
All
infants
were
followed
up
for
6
-
12
months
after
birth
.
Autopsy
was
always
performed
whenever
fetal
or
neonatal
deaths
occurred
.
Seven
patients
decided
to
undergo
fetal
therapy
,
and
eight
elected
to
continue
with
expectant
observation
.
One
fetus
died
before
early
fetal
cystoscopy
was
performed
.
Therefore
,
six
fetuses
underwent
early
fetal
cystoscopy
.
Urethral
atresia
was
diagnosed
in
three
fetuses
during
fetal
cystoscopy
and
confirmed
at
autopsy
following
termination
of
pregnancy
at
19
-
20
weeks
in
all
cases
.
Posterior
urethral
valves
were
diagnosed
and
successfully
fulgurated
by
laser
during
early
cystoscopy
in
three
fetuses
,
two
of
which
survived
with
normal
renal
and
bladder
function
after
birth
;
the
remaining
fetus
had
a
postnatal
diagnosis
of
megacystis
-
microcolon
intestinal
hypoperistalsis
syndrome
and
died
neonatally
.
In
the
expectantly
managed
group
,
no
survivals
were
observed
,
even
among
cases
with
'
isolated
'
posterior
urethral
valves
.
Percutaneous
early
fetal
cystoscopy
is
feasible
for
prenatal
diagnosis
and
therapy
of
severe
megacystis
.
Diseases
Validation
Diseases presenting
"neonatal deaths"
symptom
congenital toxoplasmosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
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