[Antenatal diagnosis of obstructive uropathies]

Area of Science:

• Prenatal Medicine
• Pediatric Nephrology
• Medical Diagnostics

Background:

• Severe congenital obstructive uropathy often leads to fetal demise due to lung hypoplasia secondary to oligohydramnios.
• Previously, these severe prenatal conditions were not adequately accounted for in pediatric statistics or studied.
• Accurate prognosis of fetal urinary tract malformations is crucial for prenatal management and resource allocation.

Purpose of the Study:

• To establish methods for assessing fetal renal function to predict postnatal outcomes.
• To differentiate fetuses with lethal malformations from those who may survive with varying degrees of renal function.
• To improve prenatal counseling and management strategies for obstructive uropathy.

Main Methods:

• Analysis of fetal urine parameters, including sodium, 2-microglobulin, and calcium levels.
• Correlation of prenatal urinary findings with postnatal renal function assessments at one year of age.
• Development of criteria to stratify fetal risk based on renal function.

Main Results:

• Established correlations between specific fetal urinary parameters and one-year-old renal function.
• Identified key indicators to distinguish fetuses with non-survivable conditions from those with potential renal insufficiency or normal function.
• Demonstrated the feasibility of predicting long-term renal outcomes from prenatal assessments.

Conclusions:

• Fetal urine analysis provides a reliable method for predicting the prognosis of obstructive uropathy.
• These criteria enable clinicians to identify fetuses likely to survive, those with renal insufficiency, and those with normal renal function postnatally.
• This approach is essential for advancing prenatal medicine and improving outcomes for infants with congenital urinary tract malformations.