Fetal Shunts
What are Fetal Shunts?
Fetal shunts are minimally invasive procedures performed during pregnancy to relieve fluid or pressure in fetal body cavities or systems. Common types include vesicoamniotic shunt for urinary tract obstruction and thoracoamniotic shunt for pleural effusions.
Why are they done?
- Relieve bladder outlet obstruction by draining urine into the amniotic sac (vesicoamniotic shunt)
- Treat pleural effusion (fluid around fetal lungs) by diverting fluid into the amniotic cavity (thoracoamniotic shunt)
- Improve lung development and prevent hydrops fetalis or renal damage.
When is it performed?
Fetal shunting is typically done between 18 and 26 weeks of gestation, once the diagnosis is confirmed and fetal structures are sufficiently developed.
How is the procedure done?
- Under ultrasound guidance, a small catheter (shunt) is inserted through the mother’s abdomen and uterine wall.
- The distal end is placed in the fetal bladder or pleural space and the proximal end in the amniotic cavity.
- The shunt allows continuous drainage of fluid to relieve pressure.
- The procedure is performed under local anesthesia and takes about 30–60 minutes.
Benefits and Risks
Benefits:
- Prevents organ damage (kidney, lung) and hydrops.
- Can improve fetal survival and long-term function.
Risks:
- Shunt displacement or blockage.
- Preterm labor or membrane rupture.
- Infection, bleeding, or injury to fetus.
Frequently Asked Questions (FAQs)
What preparation is needed?
No special preparation; follow your specialist’s instructions regarding bladder filling.
Is the procedure safe?
It carries risks but may be life-saving in severe fetal conditions.
Will the shunt need replacement?
Sometimes repositioning or replacement is required if the shunt migrates.
Can I feel the shunt?
No, you should not feel the shunt; mild discomfort may occur from needle insertion.
What follow-up is needed?
Regular ultrasounds monitor shunt position and fluid drainage.