Predictive Factors of Fetal Urethral Obstruction: A Multivariate Analysis

Oliveira, Eduardo A.; Diniz, José Silvério Santos; Cabral, Antônio Carlos Vieira; Pereira, Alamanda Kfoury; Leite, Henrique Vítor; Colosimo, Enrico A.; Vilasboas, Aranaí S.

doi:10.1159/000021002

Cited by 37 publications

(29 citation statements)

References 27 publications

(30 reference statements)

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“…The final data set included 13 articles, 11,12,24,26,29,53,54,[75][76][77][78][79][80] with a total of 215 women and 33 2 × 2 tables. All included studies were observational.…”

Section: Systematic Review Of the Accuracy Of Antenatal Diagnosis Andmentioning

confidence: 99%

The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

Morris

Malin²,

Quinlan-Jones³

et al. 2013

Health Technology Assessment

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“…The final data set included 13 articles, 11,12,24,26,29,53,54,[75][76][77][78][79][80] with a total of 215 women and 33 2 × 2 tables. All included studies were observational.…”

Section: Systematic Review Of the Accuracy Of Antenatal Diagnosis Andmentioning

confidence: 99%

The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

Morris

Malin²,

Quinlan-Jones³

et al. 2013

Health Technology Assessment

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“…In the first decade of the study, infants were investigated according to a comprehensive systematic protocol described elsewhere (14)(15)(16). After 2000, we developed a more tailored clinical protocol (17)(18)(19).…”

Section: Study Protocolmentioning

confidence: 99%

Clinical Course of 822 Children with Prenatally Detected Nephrouropathies

Quirino

Diniz

Bouzada

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives With the advent of fetal screening ultrasonography, the detection of congenital anomalies of the kidney and urinary tract (CAKUT) in utero has permitted early management of these conditions. This study aims to describe the clinical course of a large cohort of patients with prenatally detected nephrouropathies.Design, setting, participants, & measurements In this retrospective cohort study, 822 patients were prenatally diagnosed with CAKUT and systematically followed up at a tertiary Renal Unit for a median time of 43 months. Variables included in the analysis were sex, laterality, fetal ultrasonography (isolated versus associated hydronephrosis), and presence/absence of nephrouropathies. The events of interest were urinary tract infection, surgical interventions, hypertension, CKD, and death. Survival analyses were performed to evaluate time until occurrence of the events of interest.Results Urinary tract infection occurred in 245 (29.8%) children, with higher risk in females (hazard ratio=1.30, 95% confidence interval=1.02-1.70, P=0.05); 22 patients (2.7%) had hypertension, and 49 (6%) patients developed CKD. The risk of CKD was greater in patients with associated hydronephrosis (hazard ratio=5.20, 95% confidence interval=2.90-9.30, P,0.001). Twelve patients (1.5%) died during follow-up. Death was significantly associated with being born during the first period of the study (hazard ratio=6.00, 95% confidence interval=1.60-22.50, P,0.001), associated hydronephrosis (hazard ratio=9.30, 95% confidence interval=2.90-29.30, P,0.001), and CKD (hazard ratio=170.00, 95% confidence interval=41.00-228.00, P,0.001).Conclusions In our series, the clinical course of prenatally detected CAKUT was heterogeneous, and those infants with associated hydronephrosis at baseline were identified as a high-risk subgroup.

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“…The developing oligohydramnios may lead to pulmonary hypoplasia. The presence of oligohydramnios is frequently associated with bladder outlet obstruction and its observation is a sign of poor prognosis [5,6] . The effect of vesicoamniotic shunting has already been described in many previous studies [7][8][9][10] .…”

Section: Discussionmentioning

confidence: 99%

Transient Urinary Ascites after Vesicocentesis Observed in a Fetus with Megacystis Caused by Posterior Urethral Valve

Hidaka¹,

Chiba²

2009

Fetal Diagn Ther

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Background: Fetal urinary ascites is a condition that is rarely encountered. A review of previous reports suggests that the clinical course of the affected fetuses is highly variable. Methods: In this report, we describe a case in which urinary ascites was observed after vesicocentesis in a fetus with megacystis caused by posterior urethral valve. Results: The urinary ascites was transient, and the fetal outcome was good after a successful vesicoamniotic shunting operation. Conclusions: In utero bladder rupture or injury and the subsequent appearance of urinary ascites may be well tolerated by the fetus. Further, spontaneous resolution can be expected during fetal life; therefore, it appears to be preferable to opt for conservative management in fetuses with urinary ascites. Urinary ascites, particularly after vesicocentesis, should be observed with extreme caution.

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Predictive Factors of Fetal Urethral Obstruction: A Multivariate Analysis

Cited by 37 publications

References 27 publications

The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

Clinical Course of 822 Children with Prenatally Detected Nephrouropathies

Transient Urinary Ascites after Vesicocentesis Observed in a Fetus with Megacystis Caused by Posterior Urethral Valve

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