Neonatal survival and kidney function after prenatal interventions for obstructive uropathies

Area of Science:

• Perinatology
• Pediatric Nephrology
• Fetal Surgery

Background:

• Prenatal interventions for lower urinary tract obstruction (LUTO) remain debated among specialists.
• Assessing early survival and renal outcomes in fetuses with LUTO is crucial.

Purpose of the Study:

• To evaluate the early survival rate in fetuses diagnosed with LUTO.
• To assess the renal function and outcomes in neonates following prenatal interventions for LUTO.

Main Methods:

• Prospective analysis of 39 singleton pregnancies with fetal LUTO.
• Vesicoamniotic shunting (VAS) performed based on local practice, with urine analysis between 13-30 weeks.
• Primary endpoints included live birth, 28-day survival, and neonatal pulmonary/renal function.

Main Results:

• 33 VAS procedures were performed; 25 fetuses survived to delivery.
• Overall 28-day survival rate was 56% (22/39).
• Renal function preservation was low at 18% (7/39); 3 neonates required temporary dialysis.

Conclusions:

• Fetal LUTO generally has an unfavorable neonatal outcome.
• Prenatal intervention via VAS did not significantly increase survival rates.
• The intervention did not guarantee the preservation of normal kidney function postnatally.