Fetal Cystoscopy for Severe Lower Urinary Tract Obstruction

Exclusion Criteria

• •1. Fetal anomaly unrelated to LUTO
• •2. Congenital cardiac anomaly
• •3. Female fetus
• •4. Increased risk for preterm labor including short cervical length (\<1.5 cm), history of incompetent cervix with or without cerclage, and previous preterm birth
• •5. Placental abnormalities (previa, abruption, accreta) known at time of enrollment
• •6. Contraindications to surgery including previous hysterotomy in active uterine segment
• •7. Technical limitations precluding fetoscopic surgery, such as uterine fibroids, fetal membrane separation, uterine anomalies incompatible with fetoscopy
• •8. Maternal-fetal Rh isoimmunization, Kell sensitization or neonatal alloimmune thrombocytopenia affecting the current pregnancy
• •9. Maternal HIV, Hepatitis-B, Hepatitis-C status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery. If the patient's HIV or Hepatitis status is unknown, the patient must be tested and found to have negative results before enrollment
• •10. Maternal medical condition that is a contraindication to surgery or anesthesia
• •11. Patient does not have health insurance to cover routine clinical care including prenatal care, prenatal ultrasound, amniocentesis, tocolysis, admission, delivery, and fetal vesico-amniotic shunting. The exception will be fetal cystoscopy which is considered an experimental procedure.
• •12. Inability to comply with travel and follow-up requirements of the trial
• •13. Participation in another intervention study that influences maternal and fetal morbidity and mortality or participation in this trial in a previous pregnancy
• •14. Patients declining invasive testing
• •15. Family does not meet psychosocial criteria including insufficient