Outcomes of fetal lower urinary tract obstruction based on timing of oligohydramnios onset.


Journal

Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540

Informations de publication

Date de publication:
22 Dec 2023
Historique:
revised: 19 11 2023
received: 29 09 2023
accepted: 01 12 2023
medline: 22 12 2023
pubmed: 22 12 2023
entrez: 22 12 2023
Statut: aheadofprint

Résumé

Fetal Lower Urinary Tract Obstruction (LUTO) is associated with oligohydramnios and significant fetal morbidity, resulting in poor lung development and perinatal death. However, oligohydramnios may develop at different gestational periods, and the impact of timing on fetal outcomes remains unknown. Our objective was to characterize the impact onset of oligohydramnios had on prenatal outcomes. This study is a retrospective cohort study of all patients with a prenatal diagnosis of LUTO at our tertiary referral center from 2014 to 2023. All patients underwent detailed ultrasonography and interdisciplinary counseling and were subsequently delivered at our institution. Data were obtained from electronic medical records and complete extraction was required for final inclusion. During the study time period, 93 patients met inclusion criteria of which 68 (73.1%) developed oligohydramnios during their pregnancy. 63 (93%) of these pregnancies resulted in livebirths with 28 (41.1%) perinatal deaths. Onset of oligohydramnios was earlier in pregnancies with perinatal death (23 vs. 28 weeks, p = 0.004) and associated with pulmonary hypoplasia. Our data show the impact of oligohydramnios timing in pregnancy on pulmonary hyperplasia and ultimately perinatal death. This allows for detailed patient counseling on the impact oligohydramnios may have on pregnancies by the gestational age of onset.

Identifiants

pubmed: 38133549
doi: 10.1002/pd.6493
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023 John Wiley & Sons Ltd.

Références

Haeri S. Fetal lower urinary tract obstruction (LUTO): a practical review for providers. Matern Health Neonatol Perinatol. 2015;1:26. https://doi.org/10.1186/s40748-015-0026-1
Berte N, Vrillon I, Larmure O, et al. Long-term renal outcome in infants with congenital lower urinary tract obstruction. Prog Urol. 2018;28(12):596-602. https://doi.org/10.1016/j.purol.2018.06.005
Keefe DT, Kim JK, Mackay E, et al. Predictive accuracy of prenatal ultrasound findings for lower urinary tract obstruction: a systematic review and Bayesian meta-analysis. Prenat Diagn. 2021;41(9):1039-1048. https://doi.org/10.1002/pd.6025
Richter J, Doktor F, Good H, et al. Trends in management of fetuses with suspected lower urinary tract obstruction (LUTO): a high-risk fetal and pediatric center experience in a universal-access-to-care system. Eur J Pediatr Surg. 2023. https://doi.org/10.1055/s-0043-1772172
Hindryckx A, De Catte L. Prenatal diagnosis of congenital renal and urinary tract malformations. Facts Views Vis Obgyn. 2011;3(3):165-174.
Ruano R, Dunn T, Braun MC, Angelo JR, Safdar A. Lower urinary tract obstruction: fetal intervention based on prenatal staging. Pediatr Nephrol. 2017;32(10):1871-1878. https://doi.org/10.1007/s00467-017-3593-8
Warring SK, Novoa V, Shazly S, et al. Serial amnioinfusion as regenerative therapy for pulmonary hypoplasia in fetuses with intrauterine renal failure or severe renal anomalies: systematic review and future perspectives. Mayo Clin Proc Innov Qual Outcomes. 2020;4(4):391-409. https://doi.org/10.1016/j.mayocpiqo.2020.04.008
Morris RK, Kilby MD. Long-term renal and neurodevelopmental outcome in infants with LUTO, with and without fetal intervention. Early Hum Dev. 2011;87(9):607-610. https://doi.org/10.1016/j.earlhumdev.2011.07.004
Nassr AA, Shamshirsaz AA, Erfani H, et al. Outcome of fetuses with lower urinary tract obstruction and normal amniotic fluid volume in second trimester of pregnancy. Ultrasound Obstet Gynecol. 2019;54(4):500-505. https://doi.org/10.1002/uog.20288
Ethun CG, Zamora IJ, Roth DR, et al. Outcomes of fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt: a single-institution experience. J Pediatr Surg. 2013;48(5):956-962. https://doi.org/10.1016/j.jpedsurg.2013.02.011
Shannon KJ, VanLoh S, Espinoza J, et al. Fetal bladder morphology as a predictor of outcome in fetal lower urinary tract obstruction. Prenat Diagn. 2023.
Barfield WD, Committee On F, Newborn. Standard terminology for fetal, infant, and perinatal deaths. Pediatrics. 2016;137(5).
Brand RA. Standards of reporting: the CONSORT, QUORUM, and STROBE guidelines. Clin Orthop Relat Res. 2009;467(6):1393-1394.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42(2):377-381.
Askenazi SS, Perlman M. Pulmonary hypoplasia: lung weight and radial alveolar count as criteria of diagnosis. Arch Dis Child. 1979;54(8):614-618.
Vergani P. Prenatal diagnosis of pulmonary hypoplasia. Curr Opin Obstet Gynecol. 2012;24(2):89-94.
Wu CS, Chen CM, Chou HC. Pulmonary hypoplasia induced by oligohydramnios: findings from animal models and a population-based study. Pediatr Neonatol. 2017;58(1):3-7.
Schittny JC. Development of the lung. Cell Tissue Res. 2017;367(3):427-444.
Sugibayashi R, Wada S, Ozawa K, et al. Prenatally diagnosed lower urinary tract obstruction: a 15-year experience at two tertiary centers in Japan. J Obstet Gynaecol Res. 2021;47(9):3091-3099.
Jeong BD, Won HS, Lee MY. Perinatal outcomes of fetal lower urinary tract obstruction after vesicoamniotic shunting using a double-basket catheter. J Ultrasound Med. 2018;37(9):2147-2156.

Auteurs

Jessian L Munoz (JL)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Sarah Tounsi (S)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Cara Buskmiller (C)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Magdalena Sanz Cortes (MS)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Roopali V Donepudi (RV)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Michael A Belfort (MA)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Ahmed A Nassr (AA)

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Classifications MeSH