Fetal Renal Anomalies Research Articles

Successful Management of a Case with Amniotic Fluid Embolism

Amniotic fluid embolism (AFE) is an obstetric emergency with high maternal and fetal mortality and morbidity. The most important factor in determining the prognosis is early diagnosis and treatment. We present a case of amniotic fluid embolism that was successfully treated with early diagnosis and intime management.
 Respiratory arrest developed during labor in a 20-year-old patient who underwent urinoma drainage and cordocentesis for fetal renal anomaly 10 days ago and then profuse bleeding occurred approximately 90 minutes after vaginal delivery. With our definition of AFE, massive blood transfusion, fibrinogen replacement and intrauterine balloon were applied quickly. The diagnosis of AFE was made clinically and excluding differential diagnoses. She was discharged without complications.

Frequency of Ultrasonographically Detectable Fetal Anomalies in Known Oligohydramnios Pregnancies

Background: The amniotic fluid protects and cushions the developing baby. Reduced amniotic fluid, or oligohydramnios, is linked to a higher rate of birth defects. Objective: To find out the frequency of ultrasonographically detectable fetal anomalies in pregnancies complicated by oligohydramnios. Study Design: Cross sectional study. Settings: Department of Diagnostic Radiology, University of Child Health Sciences (UCHS), Children Hospital, Lahore Pakistan. Duration: 6th October 2020 to 5th April 2021. Methods: A total of 173 women 19 to 40 years old having oligohydramnios during their second or third trimester of pregnancy were included. Patients with multiple gestation and intrauterine fetal death were excluded. They were scanned in detail with ultrasound machine having a convex 3.5 MHz probe for the severity of Amniotic Fluid Index (AFI) and for congenital fetal anomalies. Patients’ demographics and clinical characteristics were recorded. Results: Age range in this study was from 19 to 40 years with mean age of 27.8±5.1 years. Majority of the patients 144(83.23%) were between 25 to 35 years of age. Among pregnancies complicated by oligohydramnios, 39(22.54%) were reported to have ultrasonographically identifiable foetal abnormalities. Among the females, 58 (33.52%) had a vaginal delivery, while 115(66.47%) underwent a cesarean delivery. Still births observed in 7(4.04%), fetal renal tract anomalies 17(9.82%), fetal distress 13(7.51%), musculoskeletal anomalies 11(6.35%), cardiac anomalies 5(2.89%), central nervous system anomalies 6(3.46%), gastrointestinal anomalies 13(7.51%) hydronephrosis 6(3.46%), hydrocephalus 4(2.31%), meningocele 3(1.73%), diaphragmatic anomalies 5(2.89%) and hernias was noted in 8(4.62%) females. Lastly, multiple congenital anomalies were identified in 17(9.82%) cases. Conclusion: This study concluded that frequency of ultrasonographically detectable fetal anomalies in pregnancies complicated by oligohydramnios is quite high.

Evaluation the Prevalence of association between cranial congenital fetal anomalies and renal congenital fetal anomalies

Evaluation the Prevalence of association between cranial congenital fetal anomalies and renal congenital fetal anomalies

Five successful pregnancies with antenatal anakinra exposure.

Our aim is to add to the limited existing prospective data on IL-1 inhibitor use in pregnancy. Data were obtained from the Organization of Teratology Information Specialists Autoimmune Disease in Pregnancy Project, a prospective cohort study of pregnancy outcomes in the USA and Canada. Eligible women were enrolled prior to 19 weeks' gestation between 2004 and 2017. Outcomes were obtained by maternal interview and medical record abstraction. Five pregnancies with anakinra exposure were identified, all resulting in full-term singleton live births with no major or long-term complications. Three maternal subjects used anakinra for adult-onset Still's disease and two for systemic JIA. For all individuals who discontinued anakinra, some amount of steroid medication was necessary for treatment of disease flare. Two maternal subjects developed oligohydramnios, one also with pregnancy-induced hypertension. Two women had Caesarian sections, one medically indicated and one scheduled. One infant had low birth weight, but follow-up records indicated normal adjusted weight at 1 year. Three women successfully breastfed their infants, at least two of whom continued anakinra while breastfeeding. Anakinra was used successfully in five full-term pregnancies; however, two subjects developed oligohydramnios, a process that can be linked to fetal renal anomalies. Given previously reported cases of congenital renal anomalies associated with both antenatal anakinra use and maternal hyperthermia, the relationship between maternal IL-1 inhibitor use, uncontrolled maternal febrile disease and fetal outcomes should be further explored.

PBX1 haploinsufficiency leads to syndromic congenital anomalies of the kidney and urinary tract (CAKUT) in humans

BackgroundCongenital anomalies of the kidney and urinary tract (CAKUT) represent a significant healthcare burden since it is the primary cause of chronic kidney in children. CNVs represent a recurrent molecular...

Fetal renal anomaly: Factors that predict survival

ObjectiveTo find out the relative prevalence of renal anomalies detected in the antenatal period, and to look at factors that predict the postnatal outcome. MethodsIn this prospective study, all antenatal-detected renal anomalies booked at the tertiary health centre were evaluated and counselled. Aspects such as type of renal anomaly, oligohydramnios and presence of additional anomalies were noted. Stillborn babies underwent autopsy; all live born babies were followed for one year. Appropriate statistical analyses were performed to compare the antenatal factors with outcomes. ResultsRenal anomalies were detected in 136 out of 587 cases with major fetal anomalies. Most of the women were primiparous (65.4%). The mean gestation at presentation was 30 weeks; in 12 cases, diagnosis was possible before 20 weeks (8.8%). Antenatal hydronephrosis was the most commonly seen anomaly, with 61 cases; this was followed by bilateral cystic kidney in 50 cases. Out of the 136 cases, 12 (8.8%) underwent termination of pregnancy and 60 (44.1%) babies were stillborn. Autopsy was performed in 58 out of 72 (80.6%) cases after consent. Karyotyping was performed in 49 cases and abnormalities were detected in two (4.1%) of them. A total of 64 (47.1%) babies were live born; after one year, 49 (36.0%) of them were alive. Postnatal survival was highest in unilateral disease (85.7%). In cases with oligohydramnios, there was only 3.4% survival after one year; none of the cases with cystic kidney and oligohydramnios survived. The period of gestation at presentation of non-survivors was 25.9 weeks compared to 32.5 weeks with survivors. Among the cases with extra renal anomaly, 7.0% survived; none of the cases with associated cranio-vertebral defect or polydactyly survived after a year. ConclusionOut of the different renal pathologies that were diagnosed, survival was highest in the unilateral group. The factors associated with poor prognosis included bilateral disease, absence of amniotic fluid and presence of associated malformation.

MRI as complementary tool added to ultrasound in the diagnosis of fetal renal abnormalities – any added value?

PurposeTo assess the potential role of magnetic resonance imaging (MRI) as a complementary diagnostic tool to ultrasonography (US) in the diagnosis of fetal renal anomalies in pregnant women with oligohydramnios in the absence of amniotic membrane rupture. MethodsNinety pregnant women, with oligohydramnios were prospectively evaluated using both US and MRI. Prenatal findings were correlated with the babies’ outcome. ResultsMRI studies of diagnostic quality were obtained in all fetuses. The US and MRI findings were concordant in 79 (87.8%) of the fetuses. MRI modified and changed the diagnosis in 11 fetuses (12.2%), these were five fetuses in which US diagnosis was inconclusive, five cases in which the diagnosis changed from bilateral renal agenesis to unilateral agenesis with the other kidney multicystic dysplastic kidney (MCDK), and in the remaining fetuses the modification was from bilateral renal agenesis to unilateral agenesis with the other kidney structurally normal.Concordant findings for the prenatal US and MRI scans were seen in 100% of the autosomal recessive polycystic kidney disease (APCKD), 96% of MCDK, and 92.9% of bilateral normal kidneys. ConclusionMRI is of value in cases of oligohydramnios in limited circumstance when US findings were inconclusive.

The role of magnetic resonance imaging in refining the diagnosis of suspected fetal renal anomalies

This prospective study was designed to detect the role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies detected during screening sonography. 54 pregnant women, with suspected fetal renal anomalies detected during routine ultrasound screening, were rescanned by MRI to refine the diagnosis of the suspected renal anomalies. The pregnancy outcome was examined externally and by postnatal ultrasonography. Fifty-four cases of suspected renal anomalies detected during screening sonography of 8400 pregnant women (0.6%), were res-canned by MRI in this study. The MRI gave a similar diagnosis to postnatal ultrasound in 46 cases (16 cases of hydronephrosis, 14 cases of Polycystic Kidney Disease (PCKD), 9 cases of Multicystic Kidney Disease (MCKD), 2 cases of Renal Agensis (RA), 3 cases of single renal cyst and 2 cases of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 6 cases (4 cases of hydronephrosis diagnosed by MRI confirmed to be PCKD by postnatal ultrasound, also, 1 case of MCKD diagnosed by MRI confirmed to be hydronephrosis by postnatal ultrasound and 1 case of RA diagnosed by MRI confirmed to be normal by postnatal ultrasound). The prenatal ultrasound gave a similar diagnosis to postnatal ultrasound in 43 cases (14 cases of hydronephrosis, 13 case of PCKD, 9 cases of MCKD, 2 cases of RA, 3 cases of single renal cyst and 2 case of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 9 cases; 4 cases of hydronephrosis diagnosed by prenatal sonography confirmed to be PCKD by postnatal ultrasound, one case of PCKD+one case of MCKD, and one case of megacystis+hydroureter confirmed to be hydronephrosis by postnatal ultrasound, while one case of MCKD diagnosed by prenatal sonography was confirmed to be PCKD by postnatal ultrasound and one case of RA diagnosed by prenatal ultrasound was confirmed to be normal by postnatal ultrasound. The MRI can be used as a complementary adjunctive modality with excellent tissue contrast, especially in equivocal cases or inconclusive sonographic findings.

The role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies

Abstract Objective To detect the role of magnetic resonance imaging in refining the diagnosis of suspected fetal renal anomalies detected during screening sonography. Methods 54 pregnant women, with suspected fetal renal anomalies detected during routine ultrasound screening, were rescanned by MRI to refine the diagnosis of the suspected renal anomalies. The pregnancy outcome was examined externally and by postnatal ultrasonography. Results 54 cases of suspected renal anomalies detected during screening sonography of 8 400 pregnant women (0.6%), were rescanned by MRI in this study. The MRI diagnosed, 29 (53.7%) cases of parenchymal renal disease, 20 (37.0%) cases of hydronephrosis, 3 (5.6%) cases of single renal cyst and 2 (3.7%) cases of megacystis + hydroureter. The amniotic fluid volume was normal in 33 (61.0%) cases, while it was decreased in 21 (39.0%) cases. Two cases of chromosomal aberration (3.7%) were detected in the studied cases. During antenatal follow up of the prenatal diagnosed cases with renal anomalies 2 cases of bilateral RA (Potter's syndrome died in utero = IUFD) and out of 52 live births 1 case of NND occurred due to bilateral MCKD with trisomy 18. In this study, when the prenatal findings were compared with the postnatal findings, the MRI was 89.5% accurate, while the prenatal ultrasound was 85% accurate in diagnosing fetal renal anomalies. Conclusion The MRI can be used as a complementary adjunctive modality with excellent tissue contrast especially in equivocal cases or inconclusive sonographic findings.

Prenatal three-dimensional ultrasonography in diagnosing fetal renal anomalies

Objective To evaluate the accuracy of prenatal three-dimensional (3D) ultrasound in the diagnosis of fetal renal anomalies. Patients and methods Fifty-four pregnant women with suspected fetal renal anomalies detected during routine two-dimensional (2D) ultrasound screening after 14 weeks of gestation were rescanned by 3D ultrasound to refine the diagnosis of renal anomalies. The prenatal 3D ultrasound findings were then compared with the postnatal sonographic findings. Results The 3D ultrasound provided additional information in 25 anomalies (46.3%) and was equivalent in 29 anomalies (53.7%). The prenatal 3D ultrasound detected 29 cases (53.7%) of parenchymal renal disease, 20 cases (37%) of hydronephrosis, three cases (5.6%) of a single renal cyst, and two cases (3.7%) of megacystis and hydroureter because of a posterior urethral valve. Two extrarenal anomalies (i.e. Arnold–Chiari malformation and talipes equinovarus) were detected only by 3D ultrasound in conjunction with the bilateral two cases of hydronephrosis. Prenatal 3D ultrasound was equivalent to the postnatal ultrasonography finding in 48 out of the 52 live birth cases (92.3%). Conclusion 3D ultrasound can be used in combination with standard 2D ultrasound imaging to increase the diagnostic accuracy and provide more data than that found on 2D ultrasound.

The Wolf-Hirschhorn Syndrome in Fetal Autopsy - A Case Report -

Wolf-Hirschhorn syndrome (WHS) is one of multiple congenital anomaly/mental retardation (MCA/MR) syndromes and is caused by partial deletion of the short arm of chromosome 4, particularly in the Wolf-Hirschhorn syndrome critical region-1 (WHSCR1) and Wolf-Hirschhorn syndrome critical region-2 (WHSCR2), which are located in chromosome 4p16.3. Loss of these regions is indeed the cause of WHS, and the length of deletion regions was associated with the specific clinical phenotype. In many cases, WHS is caused by de novo deletion of the short arm of chromosome 4, including 4p16.3. A familial translocation was found in about 5-13% of WHS cases. The incidence of WHS was estimated from about 1 in 20,000 to 1 in 100,000. The key features of the WHS are, as follows: typical “Greek helmet” face (i.e., hypertelorism and frontal bossing, with prominent bridge of nose), microcephaly, cleft palate, severe psychomotor and growth retardation, low birth weight, diminished fetal activity, hypotonia, seizures and renal anomalies, which express various phenotypic features. Rarely, diaphragmatic hernia has also been reported. This report pertains to an autopsy case of WHS, of which chromosomal studies were verified by array comparative genomic hybridization (array-CGH).

Prenatal Diagnosis of Renal Developmental Anomalies Associated With an Empty Renal Fossa

Fetal kidneys are evaluated on routine obstetric ultrasounds; therefore, fetal renal developmental anomalies are frequently encountered with prenatal screening. Absence of the fetal kidney from its expected location generates a differential diagnosis that originates from the knowledge of the developmental origins of the kidneys. Many of the renal developmental anomalies demonstrate overlapping features in both symptoms and imaging appearance. We illustrate the pertinent findings of selected fetal renal anomalies in the setting of a unilateral empty renal fossa and suggest an algorithm for differentiating between the diagnoses. Discussed anomalies include horseshoe kidney, pelvic kidney, crossed fused renal ectopia, and renal agenesis.

The role of magnetic resonance imaging in fetal renal anomalies

Objective To evaluate the role of magnetic resonance imaging (MRI) in fetuses with suspected renal anomalies after ultrasonography. Methods Eighty-six consecutive singleton fetuses with suspected malformation after ultrasound underwent MRI at the All India Institute of Medical Sciences, New Delhi, India, from January 1, 2005, to July 31, 2008. The study group comprised 27 fetuses with suspected renal anomaly on ultrasound. The MRI findings were compared with the sonographic findings, and their impact on management was assessed. Postpartum imaging, autopsy, or surgical findings were taken as the gold standard of assessment and diagnosis. Results The sonographic findings in 19 (70.4%) cases were confirmed by MRI; additional findings were obtained with MRI in 7 (25.9%) cases, 3 (11.1%) of which resulted in a change in postnatal management. Additional information was also provided by MRI for 5 (50.0%) of the 10 fetuses with oligohydramnios. The MRI diagnosis was incorrect—compared with ultrasound and gold standard—for 2 (7.4%) fetuses. Conclusion Ultrasound is the imaging modality of choice for the diagnosis of fetal renal anomalies; fetal MRI is a useful adjunct, especially when ultrasound is inconclusive owing to oligohydramnios.

Complementary roles of prenatal sonography and magnetic resonance imaging in diagnosis of fetal renal anomalies

This study was designed to assess the role of magnetic resonance imaging (MRI) in refining the diagnosis of prenatally suspected fetal renal abnormalities following screening ultrasound. Twenty pregnant women, with suspected fetal renal abnormality detected during screening ultrasound and more than 14 weeks' gestation, were included in this observational prospective study at Ain Shams University Maternity Hospital from March 2004 to March 2005 after informed consent and after approval of the study protocol by the institute ethics committee. The MRI could diagnose correctly 10 cases of hydronephrosis, one case of polycystic kidney disease (PCKD), one case of RA, two normal case and two cases of intra-abdominal masses (IA Mass) (16 of 18 cases). The prenatal ultrasound could diagnose correctly eight cases of hydronephrosis, one case of PCKD, one case of renal agenesis, one case of multicystic kidney disease and one case of IA Mass (12 of 18 cases). The prenatal ultrasound and MRI gave different diagnoses in eight cases and gave the same diagnosis in 12 cases. The MRI could diagnose the aetiology of congenital renal cysts in 10 of the 20 studied cases (50%). Magnetic resonance imaging can be used as a complementary tool in the assessment of sonographically suspected fetal renal anomalies.

Abnormal first‐trimester ductus venosus blood flow: a risk factor for adverse outcome in fetuses with normal nuchal translucency

First-trimester nuchal translucency thickness (NT) is a potent tool for assessment of fetal risks of aneuploidy and other adverse outcomes. When NT is increased, Doppler assessment of the ductus venosus (DV) enhances the prediction specificity for Down syndrome. This study assessed abnormal Doppler DV waveform as a predictor of adverse outcome when the NT is normal. This was a case-control study of 2,505 consecutive patients undergoing NT screening in our certified first-trimester screening program. First-trimester Doppler assessment of DV was performed and atrial systolic velocity was rated as antegrade (normal) or absent/reversed (DV-RAV; abnormal). Each case with normal NT (< 95(th) percentile) and DV-RAV was matched with two controls with respect to maternal age within 1 year, NT within 0.2 mm, crown-rump length within 3 mm, and closest calculated aneuploidy risk. Outcomes for paired variables were compared using t-test and Chi-square test. Forty-seven (1.9%) patients had normal NT and DV-RAV. After exclusion of three cases with obvious first-trimester anomalies and two with incomplete outcome data, 42 remained for analysis. Adverse outcome included cardiovascular defects (n = 6), fetal growth restriction (n = 3), renal anomaly (n = 2), aneuploidy (n = 3) and multiple defects (n = 3), in a total of 11/42 cases (26.2%). Cardiac abnormalities, renal abnormalities and perinatal death were all significantly more common in the study group (all P < 0.05). Abnormal first-trimester DV Doppler findings appear to predict adverse outcome independently of a normal NT. These patients need detailed mid-trimester assessment of fetal anatomy with formal echocardiography, and subsequent follow-up.

The Type and Frequency of Fetal Renal Disorders and Management of Renal Pelvis Dilatation

Although fetal renal anomalies are frequently detected by prenatal ultrasonography, pre- and postnatal follow up of these disorders is not standardized. The investigators determined the incidence of the most common renal abnormalities seen in their ultrasound unit and correlated the presence of fetal renal pelvic dilatation (RPD) with the need for postnatal surgery in 342 prospectively studied fetuses who had isolated renal abnormalities and were followed from 3 months to 10 years. RPD was defined as an anteroposterior renal pelvis measurement of 4 mm or more at less than 33 weeks gestation or 7 mm or more afterward. Two thirds (227 of 342) of fetuses had RPD as their major sonographic finding. Obstructive lesions requiring surgical treatment were present in 60 fetuses (26% of all RPD cases), and the remainder had nonobstructive lesions that either resolved spontaneously or remained stable and did not require surgery. Approximately 70% of fetuses with obstructive and 77% with nonobstructive lesions were male. Other relatively frequent abnormalities included multicystic dysplastic kidney (10.5%), urinary tract duplication malformations (9.4%), and reflux (8.2%). The other category included bladder outlet obstruction, prune belly sequence, pelvic or horseshoe kidney, and bladder extrophy. Average RPD values were 11 mm in fetuses with nonobstructive conditions and 23 mm in those with obstruction. Ninety-five percent of fetuses with obstructive RPD underwent voiding cystourethrography (VCUG) and 92% had renal scintigraphy. VCUG demonstrated vesicoureteral reflux in 23% of these cases, and the renal perfusion scan showed urinary stasis in 96%. VCUG also was performed in 74% of fetuses with nonobstructive RPD but demonstrated reflux in only 4%. Among the 29% of nonobstructed fetuses who had a renal perfusion scan, 49% had urinary stasis. An obstructive process was identified in 10% of fetuses with a RPD of 6 to 10 mm (no fetuses with maximum RPD less than 6 mm required postnatal surgery); these fetuses accounted for approximately one fifth of the postnatal surgeries. Obstruction was also found in 27% of fetuses with a RPD of 11 to 20 mm (33% of all surgeries) and nearly 70% with a RPD exceeding 20 mm (48% of all surgeries). The overall ratio of obstructive to nonobstructive disorders was approximately 1:3. These findings endorse a conservative approach to prenatal sonographic monitoring of the kidneys. The RPD reflects the likelihood of obstruction, but there is substantial overlap, and in this ultrasound unit, RPD did not alter the timing of delivery. If RPD is detected early in pregnancy, a single follow-up sonographic study late in pregnancy or after delivery is sufficient.

First trimester ductus venosus doppler: An independent risk factor for adverse pregnancy outcome

FOR ADVERSE PREGNANCY OUTCOME CHIEN OH, CHRISTOPHER HARMAN, AHMET BASCHAT, University of Maryland at Baltimore, Department of Obstetrics, Gynecology and Reproductive Sciences, Baltimore, Maryland OBJECTIVE: First trimester nuchal translucency (NT) is a potent tool to assess fetal risks of aneuploidy and other adverse outcome. When NT is increased, Doppler assessment of the ductus venosus (DV) enhances specificity for Down Syndrome. This study assesses DV Doppler as a predictor of adverse outcome independent of nuchal translucency. STUDY DESIGN: Case control study of 2505 consecutive cases undergoing NT screening at our certified first trimester screening program. First trimester DV Doppler was performed, atrial velocity was rated antegrade (normal) or absent/reversed (DV RAV, abnormal). Cases with normal NT (!3.0 mm) and DV RAV were matched for maternal age within 1 year, NT within 0.2 mm, crown rump length within 3 mm, and closest calculated aneuploidy risk, with 2 controls. Outcomes were compared using t-test and Chi square for paired variables. RESULTS: Forty-eight (1.8%) patients had normal NT and DV RAV. After exclusion of 4 cases with obvious first trimester anomalies and 2 with incomplete outcome data, 42 remained for analysis. Adverse outcome included cardiovascular defects (6), fetal growth restriction (3), renal anomaly (2), aneuploidy (3) and multiple defects (3), total in 11/42 cases (26.2%). Perinatal mortality among index cases was significantly increased (Table). CONCLUSION: Abnormal first trimester DV Doppler independently predicts adverse outcome even in fetuses with normal NT. These patients need detailed midtrimester assessment of fetal anatomy with formal echocardiography, and subsequent follow up.

Fetale Harntraktveränderungen

Improvements in ultrasound technology and the appropriate timing of antenatal ultrasound has led to refined prenatal diagnosis and enhanced accuracy of diagnosis of fetal renal anomalies and makes it possible to treat obstructive and/or refluxing uropathies before the onset of clinical symptoms. The third trimester renal sonography is the most important to detect hydronephrosis amenable to treatment.Classically, the prenatal diagnosis of hydronephrosis, unilateral renal agenesis, or MDKD initiates postnatal investigations, including sonography, voiding cystourethrography (VCUG), and isotopic renography. The exact degree of renal pelvic dilatation that requires full postnatal investigation is still not entirely resolved. Most authors accept the upper limit of 7 mm for the AP diameter of the renal pelvis. The US examination should be performed after the physiological dehydration period, namely 3-5 days after birth, in an urgent case on the 1st day. A meticulous ultrasound examination performed by a physician who is familiar with the renal abnormalities shows the whole extent of underlying pathology. The role of MR urography in the work-up of renal anomalies, particularly of hydronephrosis, is currently being investigated. Due to the close developmental relationship of the urinary and genital tracts, malformations frequently occur in both of these systems. Therefore in all patients, especially in girls with renal anomalies (unilateral renal agenesis, multicystic dysplastic kidney disease), the internal genitalia need to be evaluated.

Urinary tract infections in unplanned pregnancies and fetal outcome

Aim Many pregnant women are exposed to antibiotics for urinary tract infections during pregnancy. Our aim is to bring attention to antibiotherapy in unplanned pregnancies. Method Among the 511 cases followed by our 'Toxicology Information and Follow-up Service' for drug exposure during pregnancy, 101 cases, unaware of their pregnancy, had been prescribed antibiotics and urinary antiseptic drugs in the first trimester of their unplanned pregnancies. The data on the outcome of these pregnancies and the babies were evaluated in this study. Results Of the 511 cases, 101 pregnant women were exposed to nine kinds of drugs. Seventy-five cases had healthy babies; two had babies with major malformations; one had a baby with congenital hypothyroidism; five had spontaneous abortions; and eight cases underwent induced abortions. The outcomes of eight pregnancies are unknown. Two pregnancies are still continuing without any problem. One baby had a fetal renal anomaly; however, the physical examination did not reveal any other malformations. The baby died 4 hours after delivery. Another baby had atrial septal defect, a major malformation, and one baby had congenital hypothyroidism. Conclusion Urinary tract infection is one of the most frequently seen complications of pregnancy. Our study indicated that the possibility of pregnancy should be considered when prescribing antibiotics for urinary tract infections in women of reproductive age.

Fetal, perinatal, and infant death with congenital renal anomaly

Aims: To ascertain why 19.6% of pregnancies in which a fetal renal anomaly has been detected fail to produce a surviving child, and whether antenatal diagnostic accuracy has altered since...