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1 results

  • Chapter 14.4 - Fetal urinary tract obstruction

  • from Section 2 - Fetal disease
  • Edited by Mark D. Kilby, Anthony Johnson, Baylor College of Medicine, Texas, Dick Oepkes
  • Book:
    Fetal Therapy
    Published online:
    05 February 2013
    Print publication:
    13 December 2012, pp 261-270

  • Summary

    Lower urinary tract obstruction (LUTO) is rare and is associated with significant congenital bladder neck obstruction, but also associated with high perinatal mortality and morbidity that tracks into child- and adulthood. The poor clinical outcomes associated with this disease have led to considerable research, both using animal models and clinically, to further elucidate the underlying pathogenesis of the condition and to evaluate methods of clinical diagnosis, investigation, and triage. Antenatal ultrasound diagnosis occurs prospectively in two-thirds of LUTO cases; however, other studies have shown that the timing of ultrasound is important, with <50% being detected at the routine mid-trimester scan increasing to 80% with ultrasound after 28 weeks of gestation. The basis for intervention is the theoretical belief that relief of the urinary tract obstruction will subsequently lead to a sustained improvement in fetal renal function and liquor volume.