Fetal Urinoma Secondary to Posterior Urethral Valve and Its Association to Postnatal Renal Function: A Multicenter Retrospective Study.

IF 2.7 2区 医学 Q2 GENETICS & HEREDITY Prenatal Diagnosis Pub Date : 2025-03-13 DOI:10.1002/pd.6773
Flore-Anne Martin, Matthieu Peycelon, Nicolas Vinit, Thibault Planchamp, Olivier Abbo, Maela Le Lous, Gwenaelle Le Bouar, Yves Ville, Annabelle Paye-Jaouen, Thomas Blanc, Alexis P Arnaud
{"title":"Fetal Urinoma Secondary to Posterior Urethral Valve and Its Association to Postnatal Renal Function: A Multicenter Retrospective Study.","authors":"Flore-Anne Martin, Matthieu Peycelon, Nicolas Vinit, Thibault Planchamp, Olivier Abbo, Maela Le Lous, Gwenaelle Le Bouar, Yves Ville, Annabelle Paye-Jaouen, Thomas Blanc, Alexis P Arnaud","doi":"10.1002/pd.6773","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>The role of prenatal urinoma in lower urinary tract obstruction (LUTO) such as posterior urethral valves (PUV) is debated. We aimed to describe the risk factors associated with fetal urinoma and the association between fetal urinoma and postnatal renal function before 2 years of age.</p><p><strong>Methods: </strong>This retrospective multicenter case-control study from 2000 to 2018 included pregnant patients with suspected LUTO in their male fetus on prenatal ultrasound and postnatal confirmation of PUV. The exposure criterion was prenatal urinoma. The main composit outcome (MCO) was chronic kidney disease stage 3 or higher (CKD3+) before 2 years or death. Descriptive analyses of patient data and crude and multivariate logistic regression analyses were performed in an intent-to-treat fashion, thus including lost-to-follow-up patients. Ethical approval # 20.144.</p><p><strong>Results: </strong>We included 299 patients, of whom 39 (13%) had prenatal urinoma. Thirty-eight patients had a termination of pregnancy (12.7%). Sixty-four (24.5%) patients'children were MCO positive. Twenty-one children were lost-to-follow-up, including one prenatal urinoma. Thirty-nine (60.9%) of the remaining children had CKD3+ before the age of two, of whom 6 had a prenatal urinoma (9.4%). Among the 197 children negative to the MCO, 24 had a prenatal urinoma (12.2%, p = 0.42). Four died neonatally. In livebirth patients, prenatal urinoma was associated with obstetrical complications (p = 0.02), prenatal bloodcord sample for fetal beta2-microglobulin (p = 0.01) and uro-amniotic shunt (p = 0.01). Patients with prenatal urinoma more often presented with oligohydramnios (p = 0.01) and dilated posterior urethra (p = 0.01) and were less likely to have urinary tract infections (p = 0.02), although their DMSA scan was more often altered (p = 0.001). Prenatal urinoma was not significantly associated with CKD3+ before 2 years (OR = 0.56, CI98% = 0.20-1.39, p = 0.23).</p><p><strong>Conclusion: </strong>Renal function in infants with PUV was not worsened by the presence of a prenatal urinoma. Thus, there should not be any more pejorative message conveyed to concerned couples apart from other already known prenatal poor prognosis risk factors.</p>","PeriodicalId":20387,"journal":{"name":"Prenatal Diagnosis","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prenatal Diagnosis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pd.6773","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
引用次数: 0

Abstract

Aim: The role of prenatal urinoma in lower urinary tract obstruction (LUTO) such as posterior urethral valves (PUV) is debated. We aimed to describe the risk factors associated with fetal urinoma and the association between fetal urinoma and postnatal renal function before 2 years of age.

Methods: This retrospective multicenter case-control study from 2000 to 2018 included pregnant patients with suspected LUTO in their male fetus on prenatal ultrasound and postnatal confirmation of PUV. The exposure criterion was prenatal urinoma. The main composit outcome (MCO) was chronic kidney disease stage 3 or higher (CKD3+) before 2 years or death. Descriptive analyses of patient data and crude and multivariate logistic regression analyses were performed in an intent-to-treat fashion, thus including lost-to-follow-up patients. Ethical approval # 20.144.

Results: We included 299 patients, of whom 39 (13%) had prenatal urinoma. Thirty-eight patients had a termination of pregnancy (12.7%). Sixty-four (24.5%) patients'children were MCO positive. Twenty-one children were lost-to-follow-up, including one prenatal urinoma. Thirty-nine (60.9%) of the remaining children had CKD3+ before the age of two, of whom 6 had a prenatal urinoma (9.4%). Among the 197 children negative to the MCO, 24 had a prenatal urinoma (12.2%, p = 0.42). Four died neonatally. In livebirth patients, prenatal urinoma was associated with obstetrical complications (p = 0.02), prenatal bloodcord sample for fetal beta2-microglobulin (p = 0.01) and uro-amniotic shunt (p = 0.01). Patients with prenatal urinoma more often presented with oligohydramnios (p = 0.01) and dilated posterior urethra (p = 0.01) and were less likely to have urinary tract infections (p = 0.02), although their DMSA scan was more often altered (p = 0.001). Prenatal urinoma was not significantly associated with CKD3+ before 2 years (OR = 0.56, CI98% = 0.20-1.39, p = 0.23).

Conclusion: Renal function in infants with PUV was not worsened by the presence of a prenatal urinoma. Thus, there should not be any more pejorative message conveyed to concerned couples apart from other already known prenatal poor prognosis risk factors.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Prenatal Diagnosis
Prenatal Diagnosis 医学-妇产科学
CiteScore
5.80
自引率
13.30%
发文量
204
审稿时长
2 months
期刊介绍: Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling
期刊最新文献
Fetal Urinoma Secondary to Posterior Urethral Valve and Its Association to Postnatal Renal Function: A Multicenter Retrospective Study. Challenges in Identifying the Cause of Fetal Sinus Bradycardia: Coexistence of Maternal Anti-SSA Antibodies and Holt-Oram Syndrome Due to a Novel TBX5 Variant. The Intersection Between Genetic Reproductive Carrier Screening and Genomic Newborn Screening: Implications for Clinical Practice. Exome sequencing in every pregnancy? Results of trio exome sequencing in structurally normal fetuses. Prenatal exome sequencing for the morphologically normal fetus: Should we be doing it?
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1