FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to obstetrics and fetal surgery, and can be used for antenatal correction of the fetus in obstructive uropathy. To do this, under ultrasound control and general anesthesia, a vesico-amnimal shunt is inserted into the fetal bladder and amnioinfusion is performed. The vesico-amnimal shunt is inserted into the amniotic cavity and then into the fetal bladder with an introducer, the obturator is removed, the introducer is fixed in the working position, and the conductor with a stent is inserted into the introducer tube, while the extrusor squeezes the stent into the working area. In this case, the pigtail spiral is wrapped, which ensures its fixation in the organ. Then the introducer is removed, ultrasound monitoring of the fetal heartbeat and blood flow in the umbilical artery is carried out. The next day after the operation, a repeated ultrasound examination is performed: the condition of the fetus, the position of the stent, and the amount of amniotic fluid are assessed. With an amniotic fluid index of more than 3 cm, fetal kidney function is considered sufficient for satisfactory development of the fetal lungs, amnioinfusion is not indicated. The ultrasound examination is repeated after 7 days. If the amniotic fluid index is less than 3 cm, amnioinfusion is performed. Under aseptic conditions, a 0.9% sodium chloride solution in a volume of up to 1 liter is injected into the amniotic cavity. After the manipulation, dynamic ultrasound control is performed over the condition of the fetus and the amount of amniotic fluid. With a repeated decrease in the amount of amniotic fluid - the amniotic fluid index is less than 3 cm, amnioinfusion is performed again.
EFFECT: ensures the elimination of lethal hypoplasia of the lungs due to the provision of the outflow of residual urine of the fetus and the replenishment of the lack of amniotic fluid using amnioinfusion.
1 cl, 2 ex
