Clinical outcome and follow-up of sonographically suspected in utero urinary tract anomalies.

Abstract

We determined the outcome of pregnancy and long-term renal function in cases of sonographically detected fetal urinary tract anomalies (UTAs). This was a retrospective cohort study done at an academic hospital (tertiary referral center). All records of prenatal sonographic examinations done between January 1985 and October 1994 that indicated a suspicion for UTA were examined for perinatal mortality, postnatal confirmation of sonographic diagnosis, postnatal management, and calculated creatinine clearance to determine the ultimate renal function. Of 99 cases with suspected UTAs, 28 pregnancies were terminated because the UTA was considered fatal, and 32 fetuses died perinatally. Twenty-one children are alive with good renal function, 4 with moderate renal function, and 2 with poor renal function. The prenatal diagnosis was not confirmed after birth in 12 children, all of whom are alive with good renal function. The prognosis for prenatally suspected UTA was worse in cases of bilateral involvement and in cases with associated multiple malformations. The prognosis of prenatally diagnosed UTAs depends on the specific anomaly suspected. Abnormal karyotype, other associated malformations, and bilateral involvement are unfavorable determinants of the prognosis in individual cases.