Amirhossein Moaddab1, Nicolas Sananes1, Simone Hernandez-Ruano1, Ingrid Schwach Werneck Britto1, Yair Blumenfeld1, François Stoll1, Romain Favre1, Rodrigo Ruano2. 1. Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.). 2. Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.). ruano@bcm.edu rodrigoruano@hotmail.com.
Abstract
OBJECTIVES: The purpose of this study was to evaluate the prenatal findings and postnatal outcomes in fetuses with congenital megalourethra. METHODS: This retrospective study reviewed our experience and the literature between 1989 and 2014. Prenatal findings were evaluated and compared with postnatal findings, including neonatal mortality and abnormal renal function (need for dialysis or renal transplantation). RESULTS: Fifty fetuses with congenital megalourethra were analyzed, including 6 cases diagnosed in our centers. Most cases (n = 43 [86.0%]) were diagnosed in the second trimester. Only 1 case was diagnosed in the first trimester, whereas 6 cases (12.0%) were diagnosed in the third trimester. Thirty-five fetuses (70.0%) survived. Bilateral hydroureters were associated with perinatal death (P= .024). Among the survivors, 41.9% of the neonates had renal impairment. The following factors were associated with postnatal renal impairment: presence of severe oligohydramnios/anhydramnios (P = .033), bilateral hydronephrosis (P = .008), and earlier gestational age at delivery (P = .022). CONCLUSIONS: In fetal megalourethra, bilateral hydroureters, bilateral hydronephrosis, and severe oligohydramnios/anhydramnios are associated with neonatal mortality and renal impairment.
OBJECTIVES: The purpose of this study was to evaluate the prenatal findings and postnatal outcomes in fetuses with congenital megalourethra. METHODS: This retrospective study reviewed our experience and the literature between 1989 and 2014. Prenatal findings were evaluated and compared with postnatal findings, including neonatal mortality and abnormal renal function (need for dialysis or renal transplantation). RESULTS: Fifty fetuses with congenital megalourethra were analyzed, including 6 cases diagnosed in our centers. Most cases (n = 43 [86.0%]) were diagnosed in the second trimester. Only 1 case was diagnosed in the first trimester, whereas 6 cases (12.0%) were diagnosed in the third trimester. Thirty-five fetuses (70.0%) survived. Bilateral hydroureters were associated with perinatal death (P= .024). Among the survivors, 41.9% of the neonates had renal impairment. The following factors were associated with postnatal renal impairment: presence of severe oligohydramnios/anhydramnios (P = .033), bilateral hydronephrosis (P = .008), and earlier gestational age at delivery (P = .022). CONCLUSIONS: In fetal megalourethra, bilateral hydroureters, bilateral hydronephrosis, and severe oligohydramnios/anhydramnios are associated with neonatal mortality and renal impairment.