Fetus delivered after vesico-amniotic shunt insertion

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Doctors at Gurugram’s Cloudnine hospital successfully delivered a fetus that received the city's first-ever vesico-amniotic shunt insertion. A vesico–amniotic shunt is a tube that is inserted into the unborn baby's urinary bladder. The tube drains the baby’s urine directly into the pregnancy sac containing the amniotic fluid.

This procedure was necessitated as the baby had a condition called lower urinary tract obstruction where the baby is unable to pass urine because of obstruction in the urinary system (at urethra). In this condition, urine gets accumulated in the urinary bladder resulting in kidney damage.

Not proceeding with the intervention would have resulted in serious and irreversible kidney damage. The procedure was done on the fetus at 25 weeks of gestation by Dr. Shreyasi Sharma, Fetal Medicine Consultant at Cloudnine Hospital.

The diagnosis of lower urinary tract obstruction in the fetus was first made at 24 weeks (6 months) of pregnancy. In the follow-up scans, further deterioration was observed as the urine was leaking into the baby’s abdomen. To avoid any fatal outcome, Dr. Sharma immediately performed the vesico-amniotic shunt insertion at 25 weeks of pregnancy.

Dr Sharma said, “To put it plainly, the procedure involved the insertion of a small pipe between the bladder of the unborn fetus and the pregnancy sac so that any excess fluid accumulation in the bladder gets drained into the pregnancy sac.”

“This helps in decompressing the urinary bladder. Unlike an open surgery, the procedure is technically challenging as a small structure has to be precisely placed in the right position and orientation under ultrasound guidance only, while the fetus continues to be in the mother’s womb,” she added.

Dr. Pallavi Vasal, Consulting Obstetrician at the hospital, said, “Since the conclusion of the vesico-amniotic shunt insertion, there was a remarkable improvement in all vital parameters of the pregnancy with normal fetal growth. The delivery has been smooth and uneventful. Currently, the mother and the child are under constant observation and have been doing well.”

Dr. Sanjay Wazir, Director – Paediatrics and Neonatology at the hospital, said “The baby will undergo surgery in a few days to correct the obstruction and the shunt will also be removed as part of the surgery.”


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