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Tkaczyk M, Stanczyk M, Krzeszowski W, Wojtera J, Litwinska M, Fortecka-Piestrzeniewicz K, Talar T, Pawlowska B, Olejniczak D, Podgorski M, Swiechowski R, Krygier A, Wosiak A, Szaflik K. Neonatal survival and kidney function after prenatal interventions for obstructive uropathies. Ginekol Pol 2020; 90:416-422. [PMID: 31392712 DOI: 10.5603/gp.2019.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Prenatal interventions in LUTO (lower urinary tract obstruction) usually are still question of a debate between gynaecologist and paediatric nephrologist. We aimed the study to assess the early survival rate and renal outcome in LUTO foetuses. MATERIAL AND METHODS The study was a prospective data analysis of 39 foetuses from singleton pregnancies. All pregnant women with LUTO in the foetus were qualified for VAS based on a local practice. The mean time of first urine analysis ranged between 13-30 weeks of pregnancy. Primary end-point analysis included live birth, 28d-survival, pulmonary and renal function assessment in neonatal period. RESULTS From initial number of 39, six patients miscarried before the procedure was performed. Overall, 33 VAS were performer at the mean 21 week of pregnancy (range 14-30 weeks). 25/39 foetuses survived until delivery. Three neonates died in first 3 days of life. In the first month 3 children required peritoneal dialysis, but at 28 day all children were dialysis-free. Overall survival rate at 28 day was 56%. Renal function preservation of the initial group (39) turned out to be low - 18% (7/39). CONCLUSIONS Our study showed average survival curves and complications. LUTO in the foetus had mostly unfavourable outcome in the neonatal period. The prenatal intervention did not increase it significantly and did not guarantee the preservation of normal kidney function.
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Affiliation(s)
- Marcin Tkaczyk
- Department of Paediatics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute of Lodz, Lodz, Poland
| | - Malgorzata Stanczyk
- Department of Paediatics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute of Lodz, Lodz, Poland.
| | - Waldemar Krzeszowski
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Justyna Wojtera
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Magdalena Litwinska
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Katarzyna Fortecka-Piestrzeniewicz
- Department of Intensive Therapy and Congenital Malformations of Newborns and Infants, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Tomasz Talar
- Department of Neonatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Barbara Pawlowska
- Department of Neonatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Dariusz Olejniczak
- Department of Surgery, Urology and Transplantology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Michal Podgorski
- Department of Imaging Diagnostic, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Rafal Swiechowski
- Medical Laboratory Diagnostic Centre, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Adrian Krygier
- Medical Laboratory Diagnostic Centre, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Agnieszka Wosiak
- Institute of Information Technology, Lodz University of Technology, Lodz, Poland
| | - Krzysztof Szaflik
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
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