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Войти в исследования Klinische Padiatrie · 2026
Intrauterine Ulceration of the Lower Limbs: A Not-so-rare Complication Following Vesicoamniotic Shunting with Somatex.
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Kohaut Jules, Pantani Alessia, Gottschalk Ingo, Fischer-Mertens Janina, Dübbers Martin
Аннотация
INTRODUCTION: The recent use of Somatex shunts in the prenatal drainage of megacystis remains poorly documented. Here, we describe a number of complications affecting the cutaneous and muscular tissues that have not been reported to date.
METHODS: The records of all male patients born alive after receiving a vesicoamniotic shunt were studied retrospectively. The primary end point was the presence of a cutaneous partially muscular lesion at birth. In addition, we analyzed the impact of shunt placement timing on the occurrence of these injuries.
RESULTS: Thirty patients were included. Seven patients received a Harrison fetal bladder stent, and none of them had skin ulceration visible at birth. Among the 23 patients who received a Somatex shunt, we observed ulcerative lesions of the lower limbs in 12 patients, representing 52% of children. In these patients, a single lesion was found, except for one case showing affected tissues on both lower limbs. Seventeen of these Somatex shunts were placed in the first 17 weeks of gestation. Among them, 10 showed ulcerative lesions whereas among the 6 Somatex shunts inserted later in pregnancy, two patients had an ulcerative skin lesion. There was no statistically significant difference in the occurrence of skin lesions between these two groups (10/17 vs. 2/6, p = 0.37).
CONCLUSIONS: The implantation of Somatex shunts in the prenatal treatment of megacystis is associated with cutaneous and muscular lesions in more than half of the newborns. Our results underline the importance of antenatal advice prior to the implantation of these shunts, regarding also the esthetic consequences of these lesions.
METHODS: The records of all male patients born alive after receiving a vesicoamniotic shunt were studied retrospectively. The primary end point was the presence of a cutaneous partially muscular lesion at birth. In addition, we analyzed the impact of shunt placement timing on the occurrence of these injuries.
RESULTS: Thirty patients were included. Seven patients received a Harrison fetal bladder stent, and none of them had skin ulceration visible at birth. Among the 23 patients who received a Somatex shunt, we observed ulcerative lesions of the lower limbs in 12 patients, representing 52% of children. In these patients, a single lesion was found, except for one case showing affected tissues on both lower limbs. Seventeen of these Somatex shunts were placed in the first 17 weeks of gestation. Among them, 10 showed ulcerative lesions whereas among the 6 Somatex shunts inserted later in pregnancy, two patients had an ulcerative skin lesion. There was no statistically significant difference in the occurrence of skin lesions between these two groups (10/17 vs. 2/6, p = 0.37).
CONCLUSIONS: The implantation of Somatex shunts in the prenatal treatment of megacystis is associated with cutaneous and muscular lesions in more than half of the newborns. Our results underline the importance of antenatal advice prior to the implantation of these shunts, regarding also the esthetic consequences of these lesions.