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Antenatal Workup of Early Megacystis and Selection of Candidates for Fetal Therapy.
Fontanella, Federica; Duin, Leonie; Adama van Scheltema, Phebe N; Cohen-Overbeek, Titia E; Pajkrt, Eva; Bekker, Mireille; Willekes, Christine; Bax, Caroline J; Oepkes, Dick; Bilardo, Catia M.
Afiliação
  • Fontanella F; Department of Obstetrics, Gynecology and Prenatal Diagnosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlandsfederica.fontanella@gmail.com.
  • Duin L; Department of Obstetrics, Gynecology and Prenatal Diagnosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Adama van Scheltema PN; Department of Obstetrics, Gynecology and Prenatal Diagnosis, Leiden University Medical Center, Leiden, The Netherlands.
  • Cohen-Overbeek TE; Department of Obstetrics, Gynecology and Prenatal Diagnosis, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
  • Pajkrt E; Department of Obstetrics, Gynecology and Prenatal Diagnosis, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
  • Bekker M; Department of Obstetrics, Gynecology and Prenatal Diagnosis, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Willekes C; Department of Obstetrics, Gynecology and Prenatal Diagnosis, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Bax CJ; Department of Obstetrics, Gynecology and Prenatal Diagnosis, University Medical Center, Grow School for Oncology and Medical Biology, Maastricht, The Netherlands.
  • Oepkes D; Department of Obstetrics, Gynecology and Prenatal Diagnosis, VU University Medical Center, Amsterdam, The Netherlands.
  • Bilardo CM; Department of Obstetrics, Gynecology and Prenatal Diagnosis, Leiden University Medical Center, Leiden, The Netherlands.
Fetal Diagn Ther ; 45(3): 155-161, 2019.
Article em En | MEDLINE | ID: mdl-29772579
OBJECTIVE: To investigate the best criteria for discriminating fetuses with isolated posterior urethral valves from those theoretically not eligible for fetal treatment because of complex megacystis, high chance of spontaneous resolution, and urethral atresia. METHODS: A retrospective national study was conducted in fetuses with megacystis detected before 17 weeks' gestation (early megacystis). RESULTS: In total, 142 cases with fetal megacystis were included in the study: 52 with lower urinary tract obstruction, 29 with normal micturition at birth, and 61 with miscellaneous syndromal associations, chromosomal and multiple structural abnormalities (complex megacystis). Only a nuchal translucency > 95th centile, and not a longitudinal bladder diameter ≤15 mm (p = 0.24), significantly increased the risk of complex megacystis (p < 0.01). Cases with a high chance of spontaneous resolution were identified by using the cut-off of 12 mm, as demonstrated in a previous study, and the finding of an associated umbilical cord cyst carried a high-risk of urethral atresia (odds ratio: 15; p = 0.026), an unfavorable condition for antenatal treatment. An algorithm encompassing these three criteria demonstrated good accuracy in selecting fetuses theoretically eligible for fetal treatment (specificity 73%; sensitivity 92%). CONCLUSIONS: Cases theoretically eligible for early fetal therapy are those with normal nuchal translucency, a longitudinal bladder diameter > 12 mm, and without ultrasound evidence of umbilical cord cysts.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bexiga Urinária / Terapias Fetais / Duodeno / Doenças Fetais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fetal Diagn Ther Assunto da revista: DIAGNOSTICO POR IMAGEM / OBSTETRICIA / PERINATOLOGIA Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bexiga Urinária / Terapias Fetais / Duodeno / Doenças Fetais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fetal Diagn Ther Assunto da revista: DIAGNOSTICO POR IMAGEM / OBSTETRICIA / PERINATOLOGIA Ano de publicação: 2019 Tipo de documento: Article