Diagnosis of fetal urinary tract malformations: prenatal management and postnatal outcome.

Amélie Ryckewaert-D'Halluin 1, * Gwenaelle Le Bouar 2 Sylvie Odent 3 Joëlle Milon 2 Dominique D'Hervé 4 Josette Lucas 5 Florence Rouget 1 Philippe Loget 6 Patrice Poulain 2 Edouard Le Gall 1 Sophie Taque 1
* Auteur correspondant
1 Service de médecine de l'enfant et de l'adolescent
2 Service de Gynécologie et Obstétrique [Rennes]
3 Service de Génétique Clinique
4 Clinique mutualiste La Sagesse
5 Service de Cytogénétique et de Biologie Cellulaire
6 Service d'anatomie et cytologie pathologiques [Rennes]
Abstract : OBJECTIVE: To evaluate prenatal management and to define the criteria of gravity for accurate assessment of the renal and overall prognosis of fetuses presenting malformations of the urinary tract. METHODS: We carried out a retrospective study of 127 cases of urinary tract malformation. We carried out descriptive statistical and univariate analyses as a function of severity criteria and the outcome of pregnancy. RESULTS: One-third of fetuses presented associated extrarenal malformations and 10% of the karyotypes were abnormal. There were more abortions in case of decrease in amniotic fluid volume (p < 0.001), extent of renal damage (p < 0.05), presence of associated extrarenal malformations (p < 0.05), early diagnosis of the malformation (p < 0.001) and presence of chromosomal syndrome (p = 0.01). In our study, there was an excellent correlation between prenatal data and pathological findings for the fetus following abortions for medical reasons or obtained during the surveillance of live-born children. Fetal biochemistry made very little contribution. CONCLUSION: In cases of urinary tract malformation, this work confirms the need for regular and frequent ultrasound scans, checking for the echographic factors indicative of gravity and for adapted karyotyping. It also demonstrates that pluridisciplinary management is necessary for the prenatal evaluation of renal and overall fetal prognosis.
Keywords : fetal urinary tract malformations prenatal renal function fetal prognosis
Type de document :
Article dans une revue
Prenatal Diagnosis, Wiley, 2011, 31 (11), pp.1013-20. 〈10.1002/pd.2824〉
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http://www.hal.inserm.fr/inserm-00609188
Contributeur : Hervé De Villemeur <>
Soumis le : lundi 18 juillet 2011 - 14:45:45
Dernière modification le : mercredi 16 mai 2018 - 11:24:04

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IGDR | BIOSIT | UR1-UFR-SVE | UNIV-RENNES

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Amélie Ryckewaert-D'Halluin, Gwenaelle Le Bouar, Sylvie Odent, Joëlle Milon, Dominique D'Hervé, et al.. Diagnosis of fetal urinary tract malformations: prenatal management and postnatal outcome.. Prenatal Diagnosis, Wiley, 2011, 31 (11), pp.1013-20. 〈10.1002/pd.2824〉. 〈inserm-00609188〉

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