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Related Experiment Video

Updated: Jun 21, 2025

Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
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Obstructive or non-obstructive megacystis: a prenatal dilemma.

Martina Mandaletti1,2, Elisa Cerchia1, Elena Ruggiero1,3

  • 1Pediatric Urology Unit, Department of Public Health and Pediatric Sciences, Regina Margherita Children's Hospital, Turin, Italy.

Frontiers in Pediatrics
|July 17, 2024
PubMed
Summary

Prenatal megacystis diagnosis, often linked to lower urinary tract obstruction (LUTO), has an 85% live birth rate. Current prenatal indicators do not predict postnatal outcomes or renal function.

Keywords:
fetallower urinary tract obstructionmegabladdermegacystisobstructed bladderoligohydramniosprenatal diagnosis

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Area of Science:

  • Perinatology
  • Fetal Medicine
  • Pediatric Urology

Background:

  • Prenatal diagnosis of megacystis significantly impacts pregnancy outcomes and fetal development.
  • Distinguishing between obstructive and non-obstructive causes is crucial for predicting postnatal health.
  • Adverse effects on fetal/neonatal survival and organ function necessitate further investigation.

Purpose of the Study:

  • Investigate the natural history of fetal megacystis.
  • Differentiate in utero congenital lower urinary tract obstruction (LUTO) from non-obstructive megacystis.
  • Predict postnatal outcomes and renal function based on prenatal findings.

Main Methods:

  • Retrospective observational study (July 2015-November 2023) of fetuses with specific bladder diameter criteria.
  • Inclusion: longitudinal bladder diameter >7mm (1st trimester) or overdistended/thickened bladder failing to empty (2nd/3rd trimesters).
  • Utilized ultrasound, genetic testing, prenatal counseling, and postnatal follow-up; stratified patients by diagnosis (LUTO, non-LUTO, normal urinary tract).

Main Results:

  • 27 fetuses included (26 male); 92% diagnosed in 2nd/3rd trimesters.
  • 85% live births (23 neonates), with 2 postnatal deaths due to malformations.
  • No evaluated prenatal parameters (e.g., upper tract dilatation, keyhole sign, LBD, GA) predicted postnatal diagnosis or renal function.

Conclusions:

  • Second/third-trimester megacystis diagnosis shows an 85% live birth rate, with LUTO as the primary cause.
  • This outcome may be more favorable than previously reported, impacting prenatal counseling.
  • Megacystis is a complex antenatal sign with varied prognoses beyond renal/respiratory risks.