The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

Morris, RK; Malin, GL; Quinlan-Jones, E; Middleton, LJ; Diwakar, Lavanya; Hemming, Karla; Burke, Danielle L.; Daniels, JP; Denny, Elaine; Barton, P; Roberts, Tracy; Khan, Khalid S.; Deeks, Jonathan J; Kilby, Mark D.

doi:10.3310/hta17590

Cited by 37 publications

(51 citation statements)

References 57 publications

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“…In recent years most studies have focused on vesicioamniotic shunting. Again, however, prospective controlled trials are scarce, and those which have been conducted did not show a benefit [10]. Since clear prognostic parameters are lacking, no stratification for such interventions is possible to date.…”

Section: Introductionmentioning

confidence: 99%

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Causes of renal oligohydramnios: impact on prenatal counseling and postnatal outcome

Loos

Kemper

2017

Pediatr Nephrol

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The presence of renal oligohydramnios (ROH) in a fetus has been associated in the past with a poor prognosis for survival, although recent studies have shown that survival has improved considerably due to the advances in neonatology and pediatric nephrology. In an article recently published in Pediatric Nephrology, evaluation of a large series by Mehler and colleagues confirms the improved prognosis, showing a survival rate of 32 of 38 (84%). In addition, only 12 of 35 (34%) neonates required renal replacement therapy. In five of these 12 children the dialysis could be terminated after the neonatal period. This study has important implications on the decision-making process and counseling of families. While 37% of families of the study opted for termination of pregnancies, palliative care was chosen by 8% of the families, representing an important option when a decision cannot be made rapidly by affected families. A multidisciplinary approach is not only necessary in the active treatment of neonates with a history of ROH but also in antenatal counseling. In this regard future efforts should establish consensus on an ethical framework for the decision-making process in ROH.

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Section: Introductionmentioning

confidence: 99%

“…De-obstructive procedures (vesico-/renoamniotic shunting, aspirations from bladder/kidney or vesico-/ureteostomies) have been performed in fetuses with urinary tract obstruction to improve pre-and postnatal kidney function [9,10]. In recent years most studies have focused on vesicioamniotic shunting.…”

Section: Introductionmentioning

confidence: 99%

Causes of renal oligohydramnios: impact on prenatal counseling and postnatal outcome

Loos

Kemper

2017

Pediatr Nephrol

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“…Fetal therapy is an advancing specialty but the assessment of effectiveness for many therapies has been limited to observational data1 2 with randomised controlled trials (RCTs) employed with varying success 3 4. More recently systematic reviews have been used to assess the quality and summarise the outcomes of this evidence 5 6…”

mentioning

confidence: 99%

“…Our experiences from one such trial (the PLUTO study4) highlight the difficulties of such research. Congenital lower urinary tract obstruction (LUTO) may be identified using prenatal ultrasound and is associated with high mortality and morbidity (perinatal and childhood), due to pulmonary hypoplasia and chronic renal impairment 7–9.…”

mentioning

confidence: 99%

“…The PLUTO study aimed to determine the effectiveness, cost-effectiveness and patient acceptability of VAS for fetal LUTO, compared with conservative management. It comprised a multicentre, international RCT and a non-randomised cohort of pregnancies with LUTO (not recruited to the RCT due to patient or clinician preference) 4. All fetal medicine centres within England, Scotland and The Republic of Ireland agreed to take part in the study along with the Dutch Obstetric Research Consortium.…”

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confidence: 99%

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