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Prenatal diagnosis: does it alter outcome?

D F Thomas1

  • 1Leeds Teaching Hospitals and University of Leeds, Leeds, UK. D.F.M.Thomas@leeds.ac.uk

Prenatal Diagnosis
|December 18, 2001
PubMed
Summary
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Prenatal detection of urinary tract anomalies impacts pediatric practice, reducing severe cases through termination. However, assessing the true benefit of detecting mild anomalies remains challenging, often causing parental anxiety.

Area of Science:

  • Pediatric Urology
  • Prenatal Diagnosis
  • Medical Practice Impact

Background:

  • Prenatal detection of urinary tract anomalies is significantly altering pediatric practice.
  • The clinical outcome impact of these detections is challenging to quantify.
  • Pregnancy termination has reduced live births of infants with lethal pulmonary hypoplasia and renal dysplasia.

Purpose of the Study:

  • To evaluate the impact of prenatal detection of urinary tract anomalies on pediatric practice and clinical outcomes.
  • To assess the benefits and challenges associated with identifying fetal renal conditions.
  • To understand the implications of prenatal diagnosis on parental decisions and anxiety levels.

Main Methods:

  • Review of clinical practice changes related to prenatal ultrasound findings of urinary tract anomalies.

Related Experiment Videos

  • Analysis of trends in termination of pregnancy for fetal anomalies.
  • Assessment of the accuracy of prenatal ultrasound in identifying fetuses at risk of renal failure.
  • Evaluation of the long-term outcomes for infants with detected urinary tract anomalies.

    • Main Results:

    • Termination of pregnancy has decreased the incidence of neonates with lethal conditions like pulmonary hypoplasia and renal dysplasia.
    • Referrals for major non-lethal anomalies, such as bladder exstrophy, are declining due to increased termination rates.
    • Prenatal ultrasound can accurately identify fetuses at high risk for early-onset postnatal renal failure.
    • The actual benefit of detecting mild urinary tract dilatations is questionable, often leading to parental anxiety without significant clinical pathology.

    Conclusions:

    • Prenatal diagnosis of urinary tract anomalies influences pregnancy decisions and reduces the burden of severe neonatal conditions.
    • While effective for high-risk fetuses, the clinical utility of detecting mild anomalies requires careful consideration to avoid unnecessary parental distress.
    • Further research is needed to precisely assess the proportion of children who genuinely benefit from prenatal detection of specific urinary tract anomalies.