Tip:
Highlight text to annotate it
X
>> THE PROBLEM WITH URETHRAL OBSTRUCTION IN LUTO IS THAT
THE URINE CAN'T GET OUT SO THE BLADDER FILLS AND ENLARGES.
>> IF YOU COULD DECOMPRESS THAT URINARY TRACT,
DECOMPRESS THE BLADDER, GIVE THE URINE ANOTHER ROUTE TO
GET OUT INTO THE AMNIOTIC FLUID,
THEN YOU COULD AVERT THE PROBLEMS WITH THE LUNGS,
AVERT PULMONARY HYPOPLASIA, AND AVERT THE RENAL DAMAGE.
>> AND THAT'S THE WHOLE GENESIS OF CONSIDERING
SHUNTING OF THE FLUID OR THE URINE THAT'S IN THE BLADDER
BACK INTO THE AMNIOTIC SPACE,
RECONSTITUTING THAT SO THAT ULTIMATELY LUNGS CAN DEVELOP
NORMALLY.
>> A SHUNT TUBE PROVIDES A PASSAGEWAY FOR THE URINE
FLOW To GO FROM THE BLADDER WHICH WAS OTHERWISE
COMPLETELY OBSTRUCTED OUT INTO THE AMNIOTIC SPACE.
IT ALLOWS THE AMNIOTIC FLUID TO COME BACK,
IT ALLOWS THE LUNGS TO DEVELOP,
DECREASES THE PRESSURE ON THE DEVELOPING KIDNEYS,
AND HOPEFULLY PRESERVES RENAL FUNCTION.
>> IN UTERO INTERVENTION DOES NOT MEAN A CURE.
IT CANNOT REVERSE THE RENAL DAMAGE THAT IS ALREADY
PRESENT.
>> IT'S JUST A TEMPORARY TREATMENT AND THE REAL WORK
STARTS AFTER BIRTH.
>> THE MULTIDISCIPLINARY CONSULT TAKES PLACE TO
REALLY EDUCATE THE FAMILIES ABOUT BOTH THE RISKS AND THE
BENEFITS OF IN UTERO INTERVENTION.
>> WHEN WE REALLY GO INTO GREAT DETAIL ABOUT THE SHUNT
PROCEDURE.
>> HERE'S WHAT YOU CAN EXPECT.
HERE'S YOUR PERCENTAGES OF THIS HAPPENING OR THE OTHER
THING HAPPENING.
>> WE TALK ABOUT OUR EXPERIENCE WITH LONG-TERM
SURVIVAL AND OUTCOMES.
>> IS HE IMMEDIATELY GOING TO NEED A KIDNEY TRANSPLANT?
IS HIS BLADDER GOING TO WORK AT ALL?
>> AND WE ALSO TALK ABOUT THE POTENTIAL RISKS TO THE
MOTHER AND TO THE FETUS OF THIS PROCEDURE BECAUSE IT IS
AN INVASIVE PROCEDURE.
>> THAT MEETING, YOU KNOW, IT'S ONE OF THOSE MEETINGS,
IT'S A DECISION POINT IN YOUR LIFE WHICH YOU'LL
REMEMBER FOREVER.
>> CHOICES ARE THEIRS AND WHATEVER FAMILIES DECIDE TO
DO, WHATEVER THE MOTHER DECIDES TO DO,
IS CARRYING A BABY WITH LUTO,
THAT'S GOING TO BE THE RIGHT CHOICE FOR HER. .