Postnatal Outcomes in Cases of Prenatally Detected Dilated Fetal Bladder

Jack Bocock, Panicos Shangaris*, Massimo Garriboli andSrividhya Sankaran*

Objectives: To explore the long-term outcomes in foetuses presenting with an enlarged bladder antenatally.

Methods - Design: A retrospective cohort study was conducted over a 15-year period between 2003 and 2018.

Setting and participants: Foetuses suspected to have enlarged bladders antenatally were included.

Outcome measurements and statistical analysis: Analyses were done based on the trimester the enlarged bladder was detected, live births, terminations, surgical interventions, creatinine levels and bladder measurements post-delivery, and subsequent health outcomes.

Results: From the 50 foetuses identified prenatally, detections were as follows: first trimester (9 cases), second trimester (30 cases), and third trimester (11 cases). There were 14 terminations (28%), 5 stillbirths (10%), and 31 live births (62%). Among the terminated and stillbirth/neonatal death cases, the most frequent diagnosis in males was PUV (57%). Two female foetuses were terminated due to lumbosacral spina bifida and sacrococcygeal teratoma obstructing the ureters, respectively. In surviving males, PUV was predominant (48.3% of 29 males). In five cases megacystis had resolved by birth, including one following in-utero surgery. Among the two female cases, one issue was resolved by birth, and the second had bilateral ureteroceles. Post-birth, surgical intervention was needed in 61% of males and 50% of females. The commonest surgery was ablation of posterior urethral valves. The median age for surgery was 1.5 months with a median follow-up of 4 years and the longest follow-up of fourteen years. Six children had no postnatal renal or urological follow-up. The mean peak creatinine level was 132, dropping to 47 in the latest measurement. Half of the patients with pathology evident at birth exhibited abnormal bladder function. There was one neonatal death. Three patients necessitated a kidney transplant due to chronic kidney disease.

Conclusion: Foetuses diagnosed with an enlarged bladder in the second trimester most frequently had the posterior urethral valve as the underlying cause. For patients continuing the pregnancy, most had live births. About 1 in 10 posterior urethral valve survivors developed chronic kidney conditions, leading to a renal transplant.

Keywords:

Published on: Oct 30, 2024 Pages: 28-34

Full Text PDF Full Text HTML DOI: 10.17352/aur.000054
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