Percutaneous fetal surgery using epidural catheter: preliminary experience acquired from 24 cases

Objective The objective of the following study is to report the experience acquired from 24 percutaneous fetal surgeries for cavity drainage using epidural catheter instead of the commercially available catheter. Methods Twenty-four percutaneous fetal surgeries for cavity drainage were performed, due to the following anomalies: 13 cases of lower urinary tract obstruction, nine cases of pleural effusion, and two cases of pulmonary cystic adenomatoid malformation type I. In order to verify that catheter adequacy, technical and obstetric complications derived from its use were assessed. Technical complications were difficulty in inserting the catheter and/or its functionality; and obstetric complications were the presence of bleeding, amniotic infection, preterm labor or premature rupture of membranes. Results The technical complications were the following: difficulty in passing the catheter through epidural needle in one case; one case of catheter drawn back with the needle; two cases of catheter dislodgment; and four cases of non-functionality of the catheter. Among the obstetric complications, there was only one case of preterm labor, and except from one fetus with chromosomal pathology, all the other 23 newborns were alive after 1 week. Conclusions The use of the epidural catheter can be seen as a viable alternative to percutaneous surgeries of fetal cavity shunting, due to its low cost and similar complications to the use of the conventional catheter.