1. Diagnosis of fetal urinary tract malformations: prenatal management and postnatal outcome
- Author
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Ryckewaert-D'Halluin, Amélie, Le Bouar, Gwenaelle, Odent, Sylvie, Milon, Joëlle, D'Hervé, Dominique, Lucas, Josette, Rouget, Florence, Loget, Philippe, Poulain, Patrice, Le Gall, Edouard, Taque, Sophie, Service de médecine de l'enfant et de l'adolescent [CHU Rennes], CHU Pontchaillou [Rennes], Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], Service de génétique clinique [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-hôpital Sud, Clinique mutualiste La Sagesse, Service de Cytogénétique et de Biologie Cellulaire, Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], De Villemeur, Hervé, Service de médecine de l'enfant et de l'adolescent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de Génétique Clinique, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-hôpital Sud, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
- Subjects
Adult ,Male ,MESH: Abnormalities, Multiple ,Abnormal Karyotype ,MESH: Amniotic Fluid ,Gestational Age ,MESH: Prognosis ,prenatal renal function ,MESH: Pregnancy ,Pregnancy ,MESH: Gestational Age ,Prenatal Diagnosis ,[SDV.BDD] Life Sciences [q-bio]/Development Biology ,MESH: Urinary Tract ,Humans ,Abnormalities, Multiple ,MESH: Prenatal Diagnosis ,Urinary Tract ,fetal prognosis ,MESH: Prenatal Care ,[SDV.BDD]Life Sciences [q-bio]/Development Biology ,Retrospective Studies ,Ultrasonography ,MESH: Humans ,MESH: Child, Preschool ,Pregnancy Outcome ,MESH: Retrospective Studies ,MESH: Adult ,Prenatal Care ,MESH: Pregnancy Outcome ,Amniotic Fluid ,Prognosis ,MESH: Male ,Fetal Diseases ,MESH: Fetal Diseases ,Child, Preschool ,Female ,MESH: Abnormal Karyotype ,fetal urinary tract malformations ,MESH: Female - Abstract
International audience; OBJECTIVE: To evaluate prenatal management and to define the criteria of gravity for accurate assessment of the renal and overall prognosis of fetuses presenting malformations of the urinary tract. METHODS: We carried out a retrospective study of 127 cases of urinary tract malformation. We carried out descriptive statistical and univariate analyses as a function of severity criteria and the outcome of pregnancy. RESULTS: One-third of fetuses presented associated extrarenal malformations and 10% of the karyotypes were abnormal. There were more abortions in case of decrease in amniotic fluid volume (p < 0.001), extent of renal damage (p < 0.05), presence of associated extrarenal malformations (p < 0.05), early diagnosis of the malformation (p < 0.001) and presence of chromosomal syndrome (p = 0.01). In our study, there was an excellent correlation between prenatal data and pathological findings for the fetus following abortions for medical reasons or obtained during the surveillance of live-born children. Fetal biochemistry made very little contribution. CONCLUSION: In cases of urinary tract malformation, this work confirms the need for regular and frequent ultrasound scans, checking for the echographic factors indicative of gravity and for adapted karyotyping. It also demonstrates that pluridisciplinary management is necessary for the prenatal evaluation of renal and overall fetal prognosis.
- Published
- 2011