• Kyodo

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Prenatal surgery is making inroads in Japan with the approval of two advanced procedures that are being used at the National Cardiovascular Center in Suita, Osaka Prefecture.

One of the medical procedures, approved by the government last year, is to insert a catheter to help a fetus with a blocked urinary tract.

In the first weeks of pregnancy, amniotic fluid consists mainly of water from the mother. After about 12 weeks, fetal urine makes up most of the fluid.

By breathing in the fluid, the baby develops lungs. If the urinary tract is blocked there will not be enough urine and the lungs will not develop normally. The baby may also suffer renal failure.

Almost all newborns with blocked urinary tracts die from breathing problems within a year after birth. The blockage, detected by ultrasound, occurs in one out of 20,000 pregnancies, according to medical experts.

The cardiovascular center has developed a special double-basket catheter, about 4 mm diameter and 6 cm long.

The tube is inserted through the mother’s abdomen and connects the fetus’ bladder directly to the amniotic sac. The operation takes about two hours.

The center performed the procedure on a mother and child for the first time in Japan in 1988.

But the baby died six months after birth as the operation was done early enough and the baby’s lungs did not develop properly.

The center has done 12 of the operations and seven children have survived.

According to the Japan Society of Obstetrics and Gynecology, there were a total of 21 fetal catheter insertions done nationwide between 1996 and 1999 and 12 were successful.

Also approved by the government is an procedure that involves inserting a tube to remove extra fluid from a fetus’ lungs.

This situation, which occurs in one out of 250-300 pregnancies, can also disrupt lung development.

A tube is put in place by a needle that is inserted through the uterine wall. The tube then can pull out water from the lungs.

The baby needs help breathing after birth, but after a month can breath independently.

The cardiovascular center had done 13 of those operations by the end of fiscal 2004, with six babies surviving. Since government approval was granted in March 2005, the center has done one procedure in early April.

According to the society, 20 of 28 these procedures done nationwide between 1996 and 1999 were successful.

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