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Published on: June 29, 2013
Hypospadias Associated With Fetal Growth Restriction: A Multicentric Descriptive and Prognostic Cohort Study
Manon Marquet1, Olivia Anselem1, Claire Bouvattier2
1Department of Obstetrics and Gynecology, AP-HP, Port-Royal Maternity, Université Paris Cité, Paris, France.
Insights
The combination of fetal growth restriction (FGR) and hypospadias, even when appearing isolated, is linked to genetic or endocrine issues. Surgical outcomes for hypospadias can be complex, often requiring reintervention.
Area of Science:
- Medical Genetics
- Prenatal Diagnosis
- Pediatric Surgery
Background:
- Hypospadias and fetal growth restriction (FGR) are significant congenital conditions.
- The co-occurrence of FGR and hypospadias warrants further investigation into underlying abnormalities and outcomes.
Purpose of the Study:
- To determine the prevalence of genetic and endocrine abnormalities in fetuses with both FGR and hypospadias.
- To assess fetal, neonatal, and surgical outcomes in this specific patient cohort.
Main Methods:
- A multicentric retrospective study involving 82 fetuses diagnosed with FGR (<10th percentile) and hypospadias.
- Data collected included maternal, fetal, prenatal, and postnatal information, with genetic and endocrinological assessments.
Main Results:
- 17% of cases involved termination of pregnancy, and 5% had in utero deaths.
- In cases appearing isolated, 12% showed chromosomal, genetic, or endocrine abnormalities.
- 50% of hypospadias were proximal, and 50% of surgical interventions led to complications requiring reoperation.
Conclusions:
- The association of FGR and hypospadias should be carefully evaluated due to potential underlying genetic/endocrine issues, even in seemingly isolated cases.
- Surgical management for hypospadias in this context can be challenging, with a high rate of complications and reinterventions.
Objective:
To determine the prevalence of genetic and endocrine abnormalities and to assess fetal, neonatal and surgical outcomes in cases of hypospadias associated with fetal growth restriction.
Method:
A multicentric retrospective study was conducted across five prenatal diagnosis centers in Paris. The cohort encompassed all fetuses diagnosed with the combination of fetal growth restriction < 10th percentile (FGR) and hypospadias from 2013 to 2021. Maternal data, fetal outcome and results of prenatal investigations were collected, along with postnatal data, encompassing endocrinological and genetic assessments, functional aspects and surgical outcomes.
Results:
Among the 82 patients included in the cohort, there were 14 (17%) terminations of pregnancy and four (5%) in utero deaths, leaving 64 (78%) live neonates, including five (6%) with early neonatal death. Among the 52 (63%) cases where hypospadias and FGR were considered as ultrasound-isolated anomalies, six (12%, [3.2%-20.8%]) exhibited chromosomic, genetic, or endocrinological abnormalities diagnosed half prenatally and half postnatally. Fifty percent of the overall hypospadias were proximal. Most children underwent surgical intervention before reaching 2 years of age, with 50% encountering complications and often required reintervention.
Conclusion:
The association of FGR and hypospadias should not be underestimated as genetic or endocrinological abnormalities were identified even when hypospadias and FGR initially appear isolated. Additionally, the overall prognosis may be worsened using complex and iterative surgical procedures.
