Prenatally Detected Posterior Urethral Valves: Qualitative Assessment of Second Trimester Scans and Prediction of Outcome
- 1 September 1997
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of Urology
- Vol. 158 (3) , 1022-1025
- https://doi.org/10.1016/s0022-5347(01)64379-9
Abstract
Purpose: We attempted to determine if the degree of second trimester dilatation and/or other qualitative sonographic features of the fetal urinary tract are predictive of postnatal outcome in male neonates with posterior urethral valves. Materials and Methods: We reviewed ultrasound reports and/or hard copy imaging in 17 cases of posterior urethral valves initially detected on second trimester scans (median gestation 18 weeks, range 15 to 23.5). Ultrasound appearance was categorized according to the pattern and severity of dilatation, cystic change or echogenicity of the renal cortex and presence of oligohydramnios. Outcome was reviewed at a median followup of 5.7 years (range 4.4 to 10). Results: Of the 17 cases there was a poor outcome in 10, including death in 4 and chronic renal failure in 6. Seven patients were alive and well with normal renal function at followup. The prognosis in cases of moderate or severe upper tract dilatation was poor. Of the 9 patients with marked prenatal hydroureteronephrosis 8 (89%) were dead or had chronic renal failure at followup. In contrast, only 2 of the 8 patients (25%) with mild upper tract dilatation or dilatation limited to the bladder had chronic renal failure at review (p = 0.05). Three cases of prenatal renal parenchymal change and 3 of subsequent oligohydramnios had a poor outcome postnatally. Conclusions: The prognosis for boys with prenatally detected posterior urethral valves is closely associated with qualitative aspects of second trimester scan findings. This information may be of clinical value in the prenatal counseling of parents.Keywords
This publication has 10 references indexed in Scilit:
- 10-Year Experience With Prenatal Intervention for HydronephrosisJournal of Urology, 1996
- Fetal Therapy for Obstructive Uropathy: Specific Outcomes DiagnosisJournal of Urology, 1996
- Renal transplantation and chronic dialysis in children and adolescents: the 1993 annual report of the North American Pediatric Renal Transplant Cooperative StudyPediatric Nephrology, 1995
- Prenatally Detected Posterior Urethral Valves: Is Gestational age at Detection a Predictor of Outcome?Journal of Urology, 1994
- Specificity of antenatal ultrasound in the Yorkshire Region: a prospective study of 2261 ultrasound detected anomaliesBJOG: An International Journal of Obstetrics and Gynaecology, 1994
- Posterior Urethral Valves. Does Prenatal Diagnosis Influence Prognosis?British Journal of Urology, 1993
- Antenatal Diagnosis of Posterior Urethral ValvesBritish Journal of Urology, 1993
- Prognosis for Patients with Prenatally Diagnosed Posterior Urethral ValvesJournal of Urology, 1992
- Renal replacement therapy for end-stage renal failure before 2 years of ageNephrology Dialysis Transplantation, 1992
- Reference Ranges for Serum Creatinine in Infants, Children and AdolescentsAnnals of Clinical Biochemistry: International Journal of Laboratory Medicine, 1990