Ahmed A Nassr1,2, Chester Koh Koh3, Alireza A Shamshirsaz1, Jimmy Espinoza1, Haleh Sangi-Haghpeykar1, Dina Sharhan1, Stephen Welty4, Joseph Angelo5, David Roth3, Michael A Belfort1, Michael Braun5, Rodrigo Ruano6. 1. Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA. 2. Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Asiut, Egypt. 3. Division of Pediatric Urology, Texas Children's Hospital Pavilion for Women, Houston, TX, USA. 4. Department of Pediatrics, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, TX, USA. 5. Renal Section, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. 6. Department of Obstetrics and Gynecology, Mayo Clinic Fetal Diagnostic and Therapeutic Center, Mayo Clinic College of Medicine, Rochester, MN, USA.
Abstract
OBJECTIVE: To evaluate the association between ultrasonographic renal parameters and urine biochemistry in fetuses with lower urinary tract obstruction (LUTO). METHODS: Data were collected prospectively from 31 consecutive fetuses with LUTO that underwent vesicocentesis for fetal urinary biochemistry between April 2013 and September 2015. The following renal ultrasound markers were assessed immediately before the vesicocentesis: renal echogenicity, presence of cortical cysts, presence of findings suggestive of 'renal dysplasia' (hyperechogenic cystic kidneys with no cortical-medullary differentiation) and severe oligohydramnios (amniotic fluid < 5th percentile). The association of these parameters to the fetal urinary concentration of sodium, chloride, calcium, osmolality and beta2-microglobulin was investigated by logistic regression analysis. RESULTS: There was no relationship between any of the ultrasonographic fetal renal characteristics and fetal urinary biochemistry. CONCLUSIONS: In LUTO, the ultrasound appearance of the fetal kidneys and urinary biochemistry are not correlated. It may be better to take both ultrasound and biochemistry into account when evaluating fetuses with fetal LUTO.
OBJECTIVE: To evaluate the association between ultrasonographic renal parameters and urine biochemistry in fetuses with lower urinary tract obstruction (LUTO). METHODS: Data were collected prospectively from 31 consecutive fetuses with LUTO that underwent vesicocentesis for fetal urinary biochemistry between April 2013 and September 2015. The following renal ultrasound markers were assessed immediately before the vesicocentesis: renal echogenicity, presence of cortical cysts, presence of findings suggestive of 'renal dysplasia' (hyperechogenic cystic kidneys with no cortical-medullary differentiation) and severe oligohydramnios (amniotic fluid < 5th percentile). The association of these parameters to the fetal urinary concentration of sodium, chloride, calcium, osmolality and beta2-microglobulin was investigated by logistic regression analysis. RESULTS: There was no relationship between any of the ultrasonographic fetal renal characteristics and fetal urinary biochemistry. CONCLUSIONS: In LUTO, the ultrasound appearance of the fetal kidneys and urinary biochemistry are not correlated. It may be better to take both ultrasound and biochemistry into account when evaluating fetuses with fetal LUTO.