Prenatal diagnosis and intrauterine and extrauterine management of a fetus with both critical pulmonary stenosis and hydronephrosis: a case report
10.3760/cma.j.cn113903-20191113-00640
- VernacularTitle:胎儿危重肺动脉瓣狭窄合并重度肾积水的宫内及生后诊治一例
- Author:
Junjun SHEN
1
;
Chengcheng PANG
;
Liuqing YANG
;
Wei PAN
Author Information
1. 广东省心血管病研究所 广东省人民医院（广东省医学科学院） 广东省华南结构性心脏病重点实验室心脏母胎医学科，广州 510080
- From:
Chinese Journal of Perinatal Medicine
2020;23(8):545-548
- CountryChina
- Language:Chinese
-
Abstract:
We report the management of a fetus diagnosed with critical pulmonary stenosis, right ventricular hypoplasia, severe tricuspid regurgitation and severe hydronephrosis. After echocardiography and multidisciplinary team consultation, fetal pulmonary valvuloplasty was performed at 30 +3 weeks of gestation, to facilitate the development of the right ventricle and tricuspid valve. Fetal transdermal renal puncture performed at 31 weeks of gestation showed that the hydronephrotic fluid was urine. The mother gave birth vaginally at 37 +3 weeks. Prostacyclin was given to the baby to keep the ductus arteriosus open and maintain oxygen saturation above 80%. Nephrostomy was performed on the 6th day after birth for improvement of the hydronephrosis and renal function. Biventricular correction (percutaneous balloon pulmonary valvuloplasty) and left dismembered pyeloureteroplasty were successfully performed on 16 and 37 d after birth, respectively. Ultrasound follow-ups showed the structure and function of both heart and kidney recovered. We summarized the characteristics and management of fetal critical pulmonary stenosis complicated by severe hydronephrosis in this case, aiming to enhance experiences for appropriate treatment of similar cases in the future.
