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Fetal obstructive uropathy in trisomy syndromes.
F Qureshi1, S M Jacques, B Feldman
1Department of Pathology, Hutzel Hospital, Wayne State University School of Medicine, Detroit, MI 48201, USA. fqureshi@med.wayne.edu
Fetal Diagnosis and Therapy
|December 9, 2000
Summary
Fetal obstructive uropathy is linked to trisomy syndromes, particularly trisomy 18. Abnormal prostate development may cause these urinary tract issues in trisomic fetuses.
Area of Science:
- Medical Genetics
- Fetal Medicine
- Urology
Background:
- Fetal obstructive uropathy is rarely documented in trisomy syndromes.
- The connection between fetal obstructive uropathy and trisomy remains poorly understood.
Purpose of the Study:
- To investigate the occurrence and characteristics of fetal obstructive uropathy in trisomic fetuses.
- To explore the potential relationship between abnormal prostate development and obstructive uropathy in trisomy syndromes.
Main Methods:
- Evaluation of 110 fetuses with obstructive uropathy, identifying five trisomic cases (four trisomy 18, one trisomy 21).
- Detailed examination of urinary tracts in four second-trimester fetuses (three trisomy 18, one trisomy 21) post-termination.
- Comparative analysis of prostate development against age-matched controls.
Main Results:
- All four examined fetuses exhibited megacystis, abdominal distension, and underdeveloped urethras.
- Prostate development was significantly poor, with absent glandular development in all cases.
- Hydroureters and renal cystic changes were observed in three fetuses.
Conclusions:
- An unexpectedly high frequency of trisomies, especially trisomy 18, suggests a non-coincidental relationship.
- Abnormal prostate development is a potential causal factor for fetal obstructive uropathy in trisomy syndromes.
- Karyotypic analysis is crucial for managing obstructive uropathy, as fetal aneuploidy may contraindicate surgical intervention.