Clinical application of fetal urine production rate in unexplained polyhydramnios

• Published in: Ultrasound in obstetrics & gynecology 2009-11, Vol.34 (5), p.521-525
• Main Authors: Touboul, C., Picone, O., Levaillant, J. M., Boithias, C., Frydman, R., Boulvain, M., Senat, M. V.
• Format: Article
• Language: English
• Subjects: 3D ultrasound; Age; Amniotic Fluid - diagnostic imaging; amniotic fluid volume; Biological and medical sciences; bladder volume; Children; Diseases of mother, fetus and pregnancy; Diuresis - physiology; Female; Fetus - physiology; Fetuses; Gestational Age; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Infant; Infant, Newborn; Male; Medical sciences; Neonates; Obstetrics; Pediatrics; polyhydramnios; Polyhydramnios - diagnostic imaging; Polyhydramnios - etiology; Pregnancy; Pregnancy. Fetus. Placenta; prenatal urine production rate; Prognosis; Retrospective Studies; Reviews; Therapeutic applications; Ultrasonography, Prenatal - methods; Ultrasound; Urine; Urogenital System - diagnostic imaging; Urogenital System - embryology
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.6440

Objective To evaluate the clinical use of hourly fetal urine production rate (HFUPR) in polyhydramnios. Methods This was a retrospective review of 33 singleton pregnancies with polyhydramnios, 30 of them unexplained and three due to gastrointestinal atresia. HFUPR was estimated using three‐dimensional ultrasound and was compared with recently established nomograms. Abnormal midterm outcome, defined as diagnosis or persistence of pathology after the neonatal period until the age of 2 years, was analyzed according to prenatal HFUPR measurements and other polyhydramnios characteristics. Results Seventeen of the 30 fetuses with unexplained polyhydramnios had an HFUPR above the 95th centile, and five (29.4%) of them developed midterm disorders. None of the 13 with normal HFUPR developed midterm disorders. The HFUPR was 1.9 (SD, 0.7) multiples of the median (MoM) in fetuses with an adverse childhood outcome and 1.4 (SD, 1.2) in fetuses with normal childhood outcome (P = 0.34). In the three fetuses with gastrointestinal atresia, the HFUPR was significantly lower than in those with unexplained polyhydramnios (P = 0.003). Conclusion HFUPR was associated with the mechanism of polyhydramnios but failed to help in the prognosis of unexplained polyhydramnios because of lack of power. Children with prenatal unexplained polyhydramnios and HFUPR above the 95th centile should nevertheless receive detailed pediatric follow‐up. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.