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Outcome and etiologies of fetal megacystis according to the gestational age at diagnosis
Author(s) -
Bornes Marie,
Spaggiari Emmanuel,
Schmitz Thomas,
Dreux Sophie,
Czerkiewicz Isabelle,
Delezoide AnneLise,
ElGhoneimi Alaa,
Oury JeanFrançois,
Muller Françoise
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4215
Subject(s) - medicine , etiology , gestational age , urinary system , retrospective cohort study , pregnancy , obstetrics , surgery , genetics , biology
Objective To investigate the gestational age‐specific outcomes and the different etiologies of megacystis diagnosed at screening ultrasound. Methods A retrospective single‐center study was conducted between 1989 and 2009. We identified all consecutive cases of megacystis prenatally diagnosed during routine ultrasound screening. Outcome, final diagnosis, and renal function were recorded. Results Eighty‐four patients were included. An isolated lower urinary tract obstruction was observed in 38/84 (45.2%), ureterovesical reflux in 9/84 (10.7%), an associated congenital abnormality in 32/84 (38.1%) and a normal bladder in 5/84 (6%). Increased gestational age at diagnosis was correlated with an increased rate of live born children ( P < 0.01). No cases of megacystis diagnosed in the first trimester were born alive. When diagnosis of posterior urethral valves (PUV) was made in the third trimester, the ultimate survival rate was 11/13 (84.6%) compared with 3/12 (25%) for a diagnosis made in the second trimester ( P = 0.02). Conclusion Lower urinary tract obstruction is the main etiology of megacystis. Megacystis can also be part of more complex malformations. Outcome of megacystis detected in the first trimester is poor. PUV detected in the third trimester had a better overall survival rate than PUV detected in the second trimester. © 2013 John Wiley & Sons, Ltd.