FIELD: medicine; obstetrics and foetal surgery.
SUBSTANCE: invention can be used to determine indications for intrauterine shunt surgery by assessing the viability of the kidney parenchyma in urinomas and terminal hydronephrosis in the foetus using intrauterine puncture technique. An intravenous catheter is installed for continuous tocolysis during surgery, and the location of the foetus is determined under ultrasound navigation. General foetal anaesthesia is performed under ultrasound guidance and general anaesthesia. The introducer is inserted percutaneously into the anechoic formation located in the projection of the kidney. The obturator is removed from the introducer. The introducer is fixed in the working position with the fingers of the free hand. Then, foetal urine is collected using a syringe with a needle with a diameter of 18G. The volume and colour of urine are assessed, electrolytes are analysed, and a bacteriological examination is carried out. After the surgical procedure, ultrasound control is carried out: an assessment of the size of the kidney, the collecting system, the thickness of the parenchyma, its echogenicity and blood flow, and an assessment of diuresis. If diuresis is preserved and there is blood flow in the renal parenchyma of the foetus, a conclusion is made to perform an intrauterine shunt intervention to decompress the urinary system in the foetus; in the absence of visualization of diuresis and blood flow in the renal parenchyma, this surgical intervention is not performed.
EFFECT: method provides the ability to determine the viability of the kidney parenchyma with a further solution to the issue of using intrauterine shunt surgery for the purpose of decompressing the urinary system in the foetus.
1 cl, 2 ex
