Management of very young fetuses with LUTO
New guidelines for the management of fetal lower urinary tract obstruction (LUTO): The algorithm includes the following steps: treatment of fetuses with isolated severe LUTO within days from the first diagnosis (from as early as 12 weeks of gestation onward); karyotyping performed from amniotic fluid collected at the time of shunt insertion; avoidance of any treatment delays not waiting for oligohydramnios to occur; implementation of weekly follow-up monitoring over the remaining weeks of gestation; and re-intervention within days in the presence of shunt dislodgement, shunt malfunction or signs of additional severe bilateral upper urinary tract obstructions or urinary ascites.