Fetal Cystoscopy in the Management of Lower Urinary Tract Obstruction (LUTO)

Inclusion Criteria: * 18 years of age or older * Pregnant women carrying a singleton gestation and male fetus * Able to perform the procedure at a gestational age between 16 0/7 and 25 6/7 weeks of gestation * Lower urinary tract obstruction: Enlarged bladder (subjectively assessed), keyhole sign, bladder wall thickening (subjectively assessed), and bilateral hydro (uretero) nephrosis.27 * Absence of chromosomal abnormalities and other anomalies unrelated to the urinary tract obstruction. * Oligo or anhydramnios at or after 16 weeks of gestation * Evidence of conserved renal function (a Nassr et al., score of 3 or less ). * Able to understand the requirements of the study, and willing and able to consent for enrollment in the study Exclusion Criteria: * Severe maternal health condition precluding procedure. * Increased risk for preterm labor including short cervical length, history of incompetent cervix with or without cerclage, and previous preterm birth * Placental abnormalities (previa, abruption, accreta) known at time of enrollment * Contraindications to surgery including previous hysterotomy in active uterine segment (at or above the level of the round ligaments). * Maternal-fetal Rh isoimmunization, Kell sensitization or neonatal alloimmune thrombocytopenia affecting the current pregnancy * Maternal HIV, Hepatitis-B, Hepatitis-C status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery o * Female fetus * Sign…