[Intrauterine therapy for nonimmune hydrops fetalis (NIHF)--analysis of 38 cases]. / Terapia wewnatrzmaciczna w nieimmunologicznym obrzeku plodu (NIHF)--analiza 38 przypadków.

OBJECTIVE: The aim of the study was to perform an audit the results of fetal therapy in cases of nonimmune hydrops fetalis (NIHF), isolated hydrothorax and isolated ascites. METHODS: A total of 38 fetuses (17-35 weeks of pregnancy) were included in the study whereas 6 patients were excluded due to abnormal karyotype. NIHF was diagnosed in 24 cases, hydrothorax in 4 cases, and ascites in 4 cases. Shunts were implanted in 26 (81%) cases and 7 (19%) participants underwent therapeutic cordocentesis. RESULTS: After therapy anterior-posterior diameter of the right and the left lung increased to 9.6 mm (27%) and 12.4 mm (35%), respectively. Early complications were observed in 5 (16%) cases. PROM 2 (40%), fetal death 1 (20%), infection 1 (20%), and preterm delivery 1 (20%). Out of the 27 patients, 65% had a caesarian section without early complications and 35% had a vaginal delivery with 58% at term and 42% pre-term. CONCLUSIONS: Preceding results show that intrauterine therapy significantly improves prognosis of fetuses with NIHF.

[Comparative analysis of interuterine therapy of unilateral and bilateral fetal obstructive uropathy]. / Analiza pórownawcza wyników terapii wewnatrzmacicznej obustronnej i jednostronnej uropatii zaporowej.

OBJECTIVE: The goal of the work was a comparative analysis of intrauterine therapy among pregnant women with diagnosed fetal uropathy and unilateral hydronephrosis. METHODS: The study was conducted on a group of 98 pregnant women hospitalized at the Department of Gynecology Fertility and Fetal Therapy Polish Mother's Memorial Hospital between 2006-2012. The study group included 77 cases of fetal obstructive uropathy (79%) and 21 cases of unilateral hydronephrosis (21%). Both groups have been analyzed in terms of prognosis. Follow-up has been conducted and results have been statistically analyzed. RESULTS: In 11% of cases of obstructive uropathy therapy early complications were observed. The remaining 89% of the patients delivered at a later date, of which 54% after 34 weeks of pregnancy The average weight of a newborn was 2645g and Apgar score - 7.45. 73% of newborns were discharged home in good condition, with preserved diuresis. CONCLUSIONS: 1. The use of intrauterine therapy has a positive effect on fetal condition and newborn postnatal state. 2. Unilateral hydronephrosis group was characterized by a significantly longer duration of pregnancy higher birth weight, Apgar score, and greater survival of newborns. 3. In the group of obstructive uropathy survival improvement was achieved and dieresis was preserved Intrauterine interventions were associated with a low risk of complications.