An audit of delivery plans for babies with antenatal urinary tract abnormalities: the mothers' perspective

There is little evidence guiding the delivery of babies who are antenatally detected to have antenatal urinary tract abnormalities (AN-UTA), and some clinicians would deliver early purely because of AN-UTA. With growing evidence of adverse events resulting from early-term delivery this study aimed to assess delivery patterns for babies with AN-UTA.

Parents of children referred to our service with AN-UTA from May 2022- Sept 2023 were asked about their recollection of delivery discussions and methods. Data were collected on antenatal scans, delivery timing and method and then subsequent urological investigations and management were assessed.

Seventy-two babies (53 male) were included. 22 (31 %) were born via spontaneous labour and delivery, 33 underwent planned delivery for non-urological reasons and 17 (24 %) had planned delivery purely because of their AN-UTA. 11/17 of these were before 39 weeks (early-term). 3/17 (18 %) underwent emergency caesarean section for failure to progress during early induction. There was no significant difference between babies born early for AN-UTA with regards to urgent urological investigations (36 % vs. 16 %, p=0.207), nor for early surgery (27 % vs. 10 %, p=0.134).

24 % of babies had planned delivery purely for their AN-UTA, without any change to their urological management. The majority of these were <39 weeks gestation. In the absence of other maternal/fetal concerns, delivery <39 weeks should be avoided to optimise global outcomes.