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Evaluation of postnatal renal function in fetuses with bilateral obstructive uropathies by proton nuclear magnetic
M Eugène1, F Muller, M Dommergues
1Laboratoire RMN, Hôpital Saint-Louis, Paris, France.
Objectives:
To precisely evaluate fetal renal function in cases of bilateral fetal urinary tract obstruction, we analyzed fetal urine metabolites by nuclear magnetic resonance spectroscopy.
Study Design:
Fifty-six specimens of fetal urine samples in utero were retrospectively analyzed by proton nuclear magnetic resonance. Group 1 (n = 21) consisted of survivors for > or = 1 year with normal serum creatinine (< 50 mumol/L), for group 2 (n = 17) of survivors with abnormal serum creatinine (> 50 mumol/L), and group 3 (n = 18) of those with bilateral histologic dysplasia associated with fetal (termination of pregnancy) or neonatal death.
Results:
A specific nuclear magnetic resonance profile was obtained for each of the three groups of renal function. A two-dimensional representation of alanine-valine and valine-threonine concentrations allows clear differentiation between the three degrees of renal function, with a sensitivity and specificity of 88% and 86%, respectively.
Conclusions:
In fetal bilateral urinary tract obstruction a fetal urine nuclear magnetic resonance profile allows an accurate identification of renal function at birth.