title: Fetal Therapy for Isolated Aqueductal Stenosis.
abstract: Aqueductal stenosis (AS) is a form of noncommunicating hydrocephalus, which causes increased intracranial pressure secondary to obstruction of the aqueduct of Sylvius. Relief of intracranial pressure in the fetus by ventriculoamniotic shunting may diminish or even prevent permanent neurologic injury. Shunting was attempted in the 1980s but was abandoned due to technical difficulties. Given the advances in prenatal diagnosis and fetal intervention over the last 3 decades, we believe that an evidence-based reevaluation of the option is timely and appropriate. The aim of this review article is to discuss the clinical significance of the diagnosis of AS, current management strategies, current diagnostic capabilities, new shunt technology, and barriers to progress. Finally, we will advance a research agenda that will provide evidence-based management recommendations.
authors.affiliation: Departments of Obstetrics, Gynecology and Reproductive Sciences, The University of Pittsburgh School of Medicine, Pittsburgh, Pa., USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Emery
authors.forename: Stephanie
authors.initials: S
authors.lastname: Greene
authors.forename: William Allen
authors.initials: WA
authors.lastname: Hogge
mesh_terms: D005260:Female; D046128:Fetal Therapies / Q000379:methods* / Q000639:trends; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000639:trends