Favorable outcome after fetal swallowing of a Somatex® intrauterine shunt

Abstract

This report describes the ingestion of a dislodged Somatex Intrauterine Stent by the fetus. At 35 weeks one shunt was visualized in the fetal stomach, suggesting that the fetus had swallowed it. The shunt kept its position in the stomach until the last follow up scan at 37 weeks. At 38 weeks the patient went into spontaneous labor and vaginally delivered a boy weighting 3590 g. The first chest X-ray on the day of birth demonstrated the dislodged shunt in the duodenum while the other shunt drained the left kidney. The mother started breastfeeding. The x-ray on the second day of life was made after removal of the second shunt and the creation of a nephrostoma and demonstrated the dislodged shunt in the ileum. On the third day of life the shunt was found in the neonate's stool. The neonate was dismissed on day 7 with antibiotic prophylaxis. To our best knowledge this is the first report of an intrauterine ingestion of a Somatex Intrauterine Stent. It demonstrates that in the intrauterine period the shunt remains in the stomach and starts to pass the bowel after birth, probably prompted by breastfeeding. In our case the shunt was eventually excreted without any damage to the digestive system.

Keywords: Congenital urinary tract abnormalities; Fetal surgery; Neonatal surgery; Shunt complications; Vesico-amniotic shunt.

Fig. 1

Transverse view of the fetal abdomen at 35-week gestation demonstrating the shunt inside of the fetal stomach