Does the prenatal diagnosis of fetal urinary tract anomalies affect perinatal outcome?
A review of the literature is presented. Congenital renal and urinary tract anomalies are described, and the possible consequences of detecting them in utero are discussed. Prenatal detection of lethal anomalies affords the parents the option of terminating the pregnancy. If termination of pregnancy is not an acceptable option for the parents, the antenatal knowledge of lethal fetal anomaly helps the clinician to avoid unnecessary obstetric intervention, e.g., cesarean delivery for fetal distress. In certain cases of nonlethal renal and urinary tract anomalies, antenatal detection may influence both obstetric and postnatal management. It seems reasonable to anticipate that this might improve the prognosis of some children in terms of better preservation of kidney function. However, no scientific evidence is available to support such a statement. There are no randomized trials evaluating the outcome of congenital renal and urinary tract anomalies using different prenatal and postnatal diagnostic and therapeutic approaches. It is hoped that further research will lead to more rational antenatal and postnatal management protocols.
Department of Obstetrics and Gynecology, University Hospital MAS, University of Lund, Malmö, Sweden. Lil.Valentin@obst.mas.lu.se
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D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000151:congenital / Q000000981:diagnostic imaging; D011247:Pregnancy; D011295:Prenatal Care; D016216:Ultrasonography, Prenatal; D014551:Urinary Tract / Q000002:abnormalities* / Q000000981:diagnostic imaging*