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Moaddab A, Sananes N, Hernandez-Ruano S, Werneck Britto IS, Blumenfeld Y, Stoll F, Favre R, Ruano R. Prenatal Diagnosis and Perinatal Outcomes of Congenital Megalourethra: A Multicenter Cohort Study and Systematic Review of the Literature. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:2057-2064. [PMID: 26446816 DOI: 10.7863/ultra.14.12064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/21/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the prenatal findings and postnatal outcomes in fetuses with congenital megalourethra. METHODS This retrospective study reviewed our experience and the literature between 1989 and 2014. Prenatal findings were evaluated and compared with postnatal findings, including neonatal mortality and abnormal renal function (need for dialysis or renal transplantation). RESULTS Fifty fetuses with congenital megalourethra were analyzed, including 6 cases diagnosed in our centers. Most cases (n = 43 [86.0%]) were diagnosed in the second trimester. Only 1 case was diagnosed in the first trimester, whereas 6 cases (12.0%) were diagnosed in the third trimester. Thirty-five fetuses (70.0%) survived. Bilateral hydroureters were associated with perinatal death (P= .024). Among the survivors, 41.9% of the neonates had renal impairment. The following factors were associated with postnatal renal impairment: presence of severe oligohydramnios/anhydramnios (P = .033), bilateral hydronephrosis (P = .008), and earlier gestational age at delivery (P = .022). CONCLUSIONS In fetal megalourethra, bilateral hydroureters, bilateral hydronephrosis, and severe oligohydramnios/anhydramnios are associated with neonatal mortality and renal impairment.
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Affiliation(s)
- Amirhossein Moaddab
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Nicolas Sananes
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Simone Hernandez-Ruano
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Ingrid Schwach Werneck Britto
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Yair Blumenfeld
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - François Stoll
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Romain Favre
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.)
| | - Rodrigo Ruano
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital Pavilion for Women, Houston, Texas USA (A.M., I.S.W.B., R.R.); Service de Gynécologie Obstétrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (N.S., F.S., R.F.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche-S 1121, Biomatériaux et Bioingénierie, Strasbourg, France (N.S.); Dr Ademir C. Ruano Maternal-Fetal Clinic, São Paulo, Brazil (S.H.-R., R.R.); and Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California USA (Y.B.).
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