![]() In addition to his prenatal diagnosis of LUTO, Mason was diagnosed with prune belly syndrome, which involves absent or deficient abdominal wall muscles, undescended testes and an abnormally dilated urinary tract. At 3 months old, the blockage in the urethra was opened and a small catheter was inserted to keep the urethra open. At 12 days old, Mason had surgery for a vesicostomy (an opening for bladder drainage) and the shunt was removed. ![]() The shunt was the only way the baby could urinate due to the blockage in his urethra - and the Fetal team wasn't sure if the blockage could eventually be fixed. He was immediately taken to the NICU without Anne being able to hold him. Mason was born May 7, 2003, weighing 6 pounds, 6 ounces. After one week of bed rest, Anne had a vaginal delivery at the Milwaukee hospital. “I still didn't know if the baby would be OK." Surgery after birthĪt 34 weeks her water broke. "It was so stressful and hard to deal with,” says Anne. Anne received four injections to increase the amniotic fluid and help prevent lung or kidney damage. The shunt didn't appear to be working - urine was not coming out of the bladder so amniotic fluid was shrinking. ![]() Things were fine until about 30 weeks into Anne’s pregnancy. "I was holding my breath each time," she recalls. Each week they returned to their specialist in Milwaukee for follow-up ultrasounds. Bed rest and follow upĪfter a week of bed rest for Anne, and continued evaluation of the shunt placement, the couple went home. The LUTO-correcting shunt was placed successfully by Mark Johnson, MD, attending physician and obstetrical director at the Center for Fetal Diagnosis and Treatment. It was confidence they passed on to the nervous parents. "They had a good feeling going into the surgery, and had a good handle on things," Anne says. I still can't believe it!"Īnne felt reassured by the experience and knowledge of the CHOP team, experts in the field of fetal medicine who were familiar with treating LUTO and knew what her baby needed to achieve a good outcome. "They made a small incision in my belly, and did the procedure through a tiny tube. The procedure was similar to amniocentesis, she says. "We spent a week undergoing all sorts of tests: an ultrafast MRI, more ultrasounds and bladder tests, and an echocardiogram to check the heart," Anne says.Īt the end of the bladder testing, the Fetal team told her they recommended going ahead with a shunt. When electrolyte and protein levels in the urine sampling indicated good kidney function, the couple traveled to Philadelphia for further testing and the possibility of having a shunt placed in utero. Since urine from the first bladder drainage is old urine, and urine from the second drainage represents urine that may have emptied from the kidneys, the third and most recent urine specimen is usually the most reliable for analysis. LUTO testing continued in Milwaukee, including a series of three serial bladder taps performed over the course of four days. "We found out that while there were a lot of issues, something could be done if certain criteria were met," says Anne. While undergoing additional LUTO testing at a children's hospital in Milwaukee, the Grahls were put in touch with experts in managing keyhole bladder: the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia (CHOP). Her local obstetrician told them there was no hope: the baby probably wouldn't survive the pregnancy. The result can be severe kidney damage (renal dysplasia) and underdevelopment of the lungs ( pulmonary hypoplasia), both life-threatening conditions. It involves obstruction of the fetal urine flow into the amniotic fluid. Their unborn baby boy had a rare birth defect called lower urinary tract obstruction (LUTO), sometimes referred to as keyhole bladder.
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