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January 1, 1982

Intervention in fetal urologic problems: too hazardous?

JAMA. 1982;247(1):19. doi:10.1001/jama.1982.03320260009005

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Advanced diagnostic techniques that uncover fetal urologic abnormalities place clinicians in a practical as well as ethical quandary (JAMA 1981;246:635-639; 774-777).

In an interview with JAMA MEDICAL NEWS, moderator R. Lawrence Kroovand, MD, summed up conclusions that he, Erich Lang, MD, Billy Arant Jr, MD, and Arnold Colodny, MD, reached during a panel discussion at the recent American Academy of Pediatrics meeting in New Orleans.

"If an infant is otherwise viable and has unilateral renal disease," he advised, "then we really shouldn't intervene; it's just too experimental to aspirate a cyst or a hydronephrotic kidney in utero." Only if the fetus has severe, life-threatening, progressive bilateral hydronephrosis should aspiration be considered, suggested Kroovand, an associate professor of urology at Wayne State University School of Medicine, Detroit.

Said Arant, an associate professor of pediatrics at Southwestern Medical School, Dallas: "We would like to prevent further damage to the urinary tract to