Clinical outcome and follow-up of sonographically suspected in utero urinary tract anomalies

• Published in: Journal of clinical ultrasound 1999-01, Vol.27 (1), p.21-28
• Main Authors: Zeijl, Charlotte, Roefs, Bart, Boer, Kees, Aronson, Daniel, van Amstel, Sjoerd Ploos, Wolf, Hans, Zondervan, Hans A.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cohort Studies; Female; Fetal Death - epidemiology; fetal urinary tract anomaly; follow-up; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Karyotyping; Kidney - abnormalities; Kidney - diagnostic imaging; Kidney - physiology; Management. Prenatal diagnosis; Medical sciences; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; prenatal diagnosis: congenital malformation; Prognosis; Retrospective Studies; ultrasonography; Ultrasonography, Prenatal; Urinary Tract - abnormalities; Urinary Tract - diagnostic imaging
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/(SICI)1097-0096(199901)27:1<21::AID-JCU4>3.0.CO;2-2

Purpose We determined the outcome of pregnancy and long‐term renal function in cases of sonographically detected fetal urinary tract anomalies (UTAs). Methods This was a retrospective cohort study done at an academic hospital (tertiary referral center). All records of prenatal sonographic examinations done between January 1985 and October 1994 that indicated a suspicion for UTA were examined for perinatal mortality, postnatal confirmation of sonographic diagnosis, postnatal management, and calculated creatinine clearance to determine the ultimate renal function. Results Of 99 cases with suspected UTAs, 28 pregnancies were terminated because the UTA was considered fatal, and 32 fetuses died perinatally. Twenty‐one children are alive with good renal function, 4 with moderate renal function, and 2 with poor renal function. The prenatal diagnosis was not confirmed after birth in 12 children, all of whom are alive with good renal function. The prognosis for prenatally suspected UTA was worse in cases of bilateral involvement and in cases with associated multiple malformations. Conclusions The prognosis of prenatally diagnosed UTAs depends on the specific anomaly suspected. Abnormal karyotype, other associated malformations, and bilateral involvement are unfavorable determinants of the prognosis in individual cases. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:21–28, 1999.