Fetal Megacystis: Etiologies, Management, and Outcome According to the Trimester

Fiévet, L.; Faure, A.; Coze, S.; Harper, Luke; Panait, Nicoleta; Braunstein, David; Carson, James L.; Gorincour, Guillaume; Chaumoître, Kathia; Guys, Jean-Michel; Alessandrini, P.; D’ercole, C.; Merrot, Thierry

doi:10.1016/j.urology.2014.02.018

Cited by 36 publications

(40 citation statements)

References 23 publications

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“…The enlarged fetal bladder, often called fetal megacystis, is easy to observe by ultrasound in the first trimester and usually defined from measuring one diameter. Obstruction of bladder outflow is usually caused by urethral valves or atresia, but can also be a complication of an obstructive uretererocoele [4]. An ureterocele might develop in fetuses with double ureteres, and the ureterocele can obstruct bladder outflow.…”

Section: Discussionmentioning

confidence: 99%

“…Fetal megacystis or enlarged urinary bladder is defined as greatest diameter > 7 mm in the first trimester [6,23], but the definition varies in the second and third trimester. One definition includes an enlarged bladder with failure to empty over a period of forty-five minutes [4]. Volume calculation might be recommended in considering the prognosis of fetuses with enlarged bladder.…”

Section: Discussionmentioning

confidence: 99%

“…Such anomalies are renal failure or lower urinary tract obstruction [1][2][3]. A large urinary bladder is also associated with aneuploidy and Prune Belly syndrome [4][5][6]. In monitoring multiple pregnancies with twin-to-twin transfusion syndrome the difference in bladder size is important [7].…”

Section: Introductionmentioning

confidence: 99%

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Repeatability of volume calculations of the fetal urinary bladder

Sætherhaug

Fasting

Røset

et al. 2016

Bladder

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OBJECTIVES:To investigate the intra-and inter-observer variation of the manual 3D Virtual Organ Computer-aided Analysis (VOCAL) in calculating fetal bladder volume and compare results from VOCAL with Sonography-based Automated Volume Count (SonoAVC) and a mathematical calculation based on three radiuses. METHODS:Forty-five women attending the second trimester routine scan at St. Olavs Hospital, Trondheim, Norway were included in a prospective observational study. 3D acquisition of the fetal bladder was performed with Voluson E8 and the results were compared with intra-class correlation coefficient (ICC), repeatability coefficient and limits of agreement. RESULTS:Good intra-observer agreement for both examiners was observed. ICCs were 0.98 and 0.99 and the repeatability coefficients were ± 27 and ± 25 mm 3 . However, we found a significant difference between the two observers. The mean difference was 20 mm 3 (95% CI 9-32). Inter-observer ICC was 0.96. The mean volume based on radiuses was 148 (SD 14) mm 3 vs. 145 (SD 14) mm 3 based on VOCAL and 161 (SD 16) mm 3 based on SonoAVC. The mean volume based on SonoAVC was significant larger than volumes based on radiuses. The ICCs between methods were good and varied from 0.82 to 0.93. The mean time used in calculating volumes was 94 seconds using VOCAL, 86 seconds using SonoAVC and 28 seconds calculating from radiuses.CONCLUSIONS: VOCAL and SonoAVC did not show advantages compared to calculations based on radiuses. Therefore, we recommend calculating volumes of spherical fetal organs from three radiuses because this method was easiest to perform.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Repeatability of volume calculations of the fetal urinary bladder

Sætherhaug

Fasting

Røset

et al. 2016

Bladder

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“…These findings most likely indicate hypomotility of the ureter. Other differential diagnoses to consider include partial urethral occlusion, vesicoureteral reflux and PBS [25]. Prenatal diagnosis can be challenging based on ultrasonography with a report quoting only 26% correct diagnoses being achieved antenatally [4].…”

Section: Discussionmentioning

confidence: 99%

Megacystis Microcolon Intestinal Hypoperistalsis Syndrome: Case Reports and Discussion of the Literature

Sousa¹,

Upadhyay

Stone

2015

Fetal Diagn Ther

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Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is a rare intestinal dysmotility condition that also involves a dilated urinary bladder. It was believed to be an autosomal recessive condition, but genetic studies have suggested possibly an autosomal dominant inheritance pattern. Prenatal diagnosis can be challenging, but MRI and amniotic fluid/digestive fluid studies may be complementary investigations to improve diagnostic accuracy. Prognosis of MMIHS is generally poor and treatment is mostly supportive. To date, bowel transplantation remains the only viable treatment to restore bowel motility. Here we present two additional cases to contribute towards the scant literature on this condition.

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“…12 Sonuç olarak, ilk trimesterde yakalanan megasistislerde mesane çıkış obstrüksiyonu ağır ise prognoz olumsuz olmakta hafif megasistislerde ise kromozom normal olduğunda prognoz iyi olmaktadır. Ancak prenatal ve postnatal takip ve tedavi gereksinimi devam etmektedir.…”

Section: Discussionunclassified