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Research paper
Published online: 2021-04-08
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Predictors of poor neonatal outcomes in fetuses diagnosed with congenital urinary tract anomalie

Sonja Pop-Trajkovic Dinic, Radomir Zivadinovic, Milan Stefanovic, Milan Trenkic, Jelena Milosevic, Dejan Mitic
DOI: 10.5603/GP.a2021.0032
·
Pubmed: 33844244

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-04-08

Abstract

Objectives: Urinary tract anomalies account for approximately one-quarter of all antenatally detected anomalies. The aim
of this study was to identify factors associated with severe adverse neonatal outcomes of a prenatally diagnosed urinary
tract anomaly.
Material and methods: A retrospective-prospective study included 101 pregnant women with prenatally diagnosed fetal
urinary tract anomalies presented to the Council for Fetal Anomalies. Prenatal diagnoses were compared with autopsy
findings in cases of terminated pregnancy or with clinical and operative findings of the infants.
Results: The mortality rate in the group of patients with fetal obstructive uropathy (60 patients) was 10% and in the group
of patients with fetal multicystic dysplastic kidney (38 patients) 15.7%. Surgery was performed on 53.4% of the children,
whereas more than half of the operations involved resolving associated urinary tract anomalies. Postoperative renal function
deterioration occurred in 19% of the children.
Conclusions: The prognosis of renal function in obstructive uropathies is excellent if oligoamnios does not develop prenatally
and in case of timely provided surgical care is provided postnatally. The finding of the bilateral multicystic dysplastic
kidney is associated with poor prognosis. The prognosis in fetal unilateral multicystic dysplastic kidney depends primarily
on the condition of the contralateral kidney and the existence of associated anomalies.

Abstract

Objectives: Urinary tract anomalies account for approximately one-quarter of all antenatally detected anomalies. The aim
of this study was to identify factors associated with severe adverse neonatal outcomes of a prenatally diagnosed urinary
tract anomaly.
Material and methods: A retrospective-prospective study included 101 pregnant women with prenatally diagnosed fetal
urinary tract anomalies presented to the Council for Fetal Anomalies. Prenatal diagnoses were compared with autopsy
findings in cases of terminated pregnancy or with clinical and operative findings of the infants.
Results: The mortality rate in the group of patients with fetal obstructive uropathy (60 patients) was 10% and in the group
of patients with fetal multicystic dysplastic kidney (38 patients) 15.7%. Surgery was performed on 53.4% of the children,
whereas more than half of the operations involved resolving associated urinary tract anomalies. Postoperative renal function
deterioration occurred in 19% of the children.
Conclusions: The prognosis of renal function in obstructive uropathies is excellent if oligoamnios does not develop prenatally
and in case of timely provided surgical care is provided postnatally. The finding of the bilateral multicystic dysplastic
kidney is associated with poor prognosis. The prognosis in fetal unilateral multicystic dysplastic kidney depends primarily
on the condition of the contralateral kidney and the existence of associated anomalies.

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Keywords

fetus; congenital; urinary tract; anomalies; outcome

About this article
Title

Predictors of poor neonatal outcomes in fetuses diagnosed with congenital urinary tract anomalie

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-04-08

DOI

10.5603/GP.a2021.0032

Pubmed

33844244

Keywords

fetus
congenital
urinary tract
anomalies
outcome

Authors

Sonja Pop-Trajkovic Dinic
Radomir Zivadinovic
Milan Stefanovic
Milan Trenkic
Jelena Milosevic
Dejan Mitic

References (21)
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