The challenges of interventional trials in fetal therapy

Fetal therapy is an advancing specialty but the assessment of effectiveness for many therapies has been limited to observational data1 2 with randomised controlled trials (RCTs) employed with varying success.3 4 More recently systematic reviews have been used to assess the quality and summarise the outcomes of this evidence.5 6 Our experiences from one such trial (the PLUTO study4) highlight the difficulties of such research. Congenital lower urinary tract obstruction (LUTO) may be identified using prenatal ultrasound and is associated with high mortality and morbidity (perinatal and childhood), due to pulmonary hypoplasia and chronic renal impairment.7–9 Ultrasound-directed, in utero, vesicoamniotic shunting (VAS) bypasses the congenital urethral obstruction with the aim of improving fetal outcome.1 2 10 Counselling parents faced with the difficult and...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Obstetrics and gynaecology, Urology, Oesophagus, Clinical trials (epidemiology), Epidemiologic studies, Stroke, Pregnancy, Reproductive medicine, Child health, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Leading articles Source Type: research