Fetal Treatment of Galenic Malformations

You may not qualify if:

• Extensive fetal brain parenchymal injury/gliosis, \>10% of supratentorial brain volume (i.e., SFP presentation). This is a degree of fetal brain injury beyond which the risk of significant neurological morbidity is high, based on studies of prenatal ischemic stroke.
• Irreversible fetal non-brain organ injury (e.g. hydrops fetalis as a manifestation of heart failure, a finding which portends fatal outcome in fetuses with vein of Galen malformation), i.e., SFP presentation.
• Fetus with VOGM in whom the straight sinus or falcine sinus draining the prosencephalic varix measures less than 7 mm on fetal MRI (T2-weighted coronal slice, medio-lateral diameter measured at the narrowest point of the sinus along the anterior-posterior axis), fitting fetal MRI criteria for likely evolution into the IT cohort.
• Severe maternal obesity pre-pregnancy as defined by body mass index (BMI) of 40 or greater.
• Fetuses with major congenital anomalies.
• Evidence of preterm labor, rupture of membranes or abruption.
• Maternal coagulopathy: INR \> 1.2; PT/PTT above normal ranges for the lab; platelets \<100.
• Medical disease requiring current anticoagulation including maternal deep vein thrombosis.
• Prior maternal medical history that would preclude epidural anesthesia.
• Multi-fetal pregnancy.
• Placenta previa or accreta.
• Participation in another fetal study that influences maternal and fetal morbidity and mortality.
• Known maternal hypersensitivity to 316LM stainless steel.
• Supine hypotensive syndrome.