Perinatal outcome in fetuses with megacystis in the first half of pregnancy.
OBJECTIVE
To present the outcome of a consecutive series of 19 fetuses referred to our center for megacystis in the first half of the pregnancy.


METHODS
Retrospective analysis.


METHODS
19 cases of early fetal megacystis were reviewed. Inclusion criteria were the visualization of an enlarged bladder with a maximum longitudinal diameter >10 mm and a gestational age of no more than 19 weeks.


RESULTS
The median gestational age at diagnosis was 16 weeks (range 12-19 weeks). The median maximum longitudinal diameter of the fetal bladder at the time of diagnosis was 21 mm (range 11-35 mm). The fetal megacystis was associated with another extra renal anomaly in six cases (30%). There was no fetus with abnormal karyotype. Termination of pregnancy was performed in 11 cases because of the severity of the renal disease. One spontaneous intrauterine death occurred. A vesicoamniotic shunt was inserted in three cases, two of which died in utero. The surviving fetus that was shunted died in the neonatal period from acute renal failure. In the remaining four fetuses, resolution of the megacystis occurred spontaneously (n = 2) or following serial single-needle aspiration (n = 2). One of these had renal insufficiency requiring kidney transplantation.


CONCLUSIONS
The outcome of fetuses with early obstructive uropathy is poor, with or without in utero therapy. Pathophysiology, clinical presentation and outcome of fetuses with early uropathy may differ from those previously described in the latter part of pregnancy.
Jouannic
Jean-Marie
JM
Academic Department of Obstetrics and Gynaecology, University College London, London, UK. jean-marie.jouannic@nck.ap-hop-paris.fr
Hyett
Jon A
JA
Pandya
Pranav P
PP
Gulbis
Béatrice
B
Rodeck
Charles H
CH
Jauniaux
Eric
E
D000025:Abortion, Eugenic; D000328:Adult; D015415:Biomarkers / Q000652:urine; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000196:embryology* / Q000652:urine; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000150:complications / Q000196:embryology* / Q000652:urine; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D016482:Urinalysis; D001743:Urinary Bladder / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery
D015415:Biomarkers