Obstruction of the fetal urinary tract: a role for surgical intervention in utero?

Obstruction of the lower urinary tract was diagnosed by ultrasound in 11 fetuses. One pregnancy was therapeutically aborted. Four of the neonates died within 48 hours because of pronounced pulmonary hypoplasia, which is associated with obstruction of the urinary tract. The remaining six survived with adequate renal function but one, now aged 4, is obviously too small for his age. Intervention in utero for obstruction of the urinary tract is safe, but those fetuses for whom it is appropriate cannot yet be identified because of difficulties in diagnosing the condition of the whole fetus.