Postnatal outcome of fetal hydronephrosis: Implications for prenatal counselling

Objectives: Our goal was to provide a better understanding of isolated short corpus callosum (SCC) regarding prenatal diagnosis and postnatal outcome. Methods: We retrospectively reviewed prenatal and postnatal imaging, clinical, and biological data from 42 cases with isolated SCC. Results: Prenatal imaging showed SCC in all cases (n = 42). SCC was limited to rostrum and/or genu and/or splenium in 21 cases, involved body in 16 cases, and was more extensive in 5 cases. Indirect imaging features included typical buffalo horn ventricles (n = 14), septal dysmorphism (n = 14), parallel lateral ventricles (n = 12), and ventriculomegaly (n = 4), as well as atypical features in 5 cases. SCC was associated with interhemispheric cysts and pericallosal lipomas in 3 and 6 cases, respectively. Aneuploidy was found in 2 cases. Normal psychomotor development, mild developmental disorders, and global developmental delay were found in 70, 15, and 15% of our cases, respectively. Conclusions: SCC should be investigated to look for pericallosal lipoma and typical versus atypical indirect features of corpus callosum agenesis (CCA). Prenatal counselling should be guided by imaging as well as clinical and genetic context. Outcome of patients with SCC was similar to the one presenting with complete CCA.

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G235(P) Isolated fetal hydronephrosis: sonographic predictors of adverse postnatal outcome

10.1136/archdischild-2019-rcpch.229 ◽

2019 ◽

Author(s):

J Wilkins ◽

H Lambert ◽

S Robson

Keyword(s):

Fetal Hydronephrosis ◽

Postnatal Outcome

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Prenatal diagnosis, associated findings and postnatal outcome in fetuses with congenitally corrected transposition of the great arteries

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05886-8 ◽

2020 ◽

Author(s):

Andrea Krummholz ◽

I. Gottschalk ◽

A. Geipel ◽

U. Herberg ◽

C. Berg ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Fetal Echocardiography ◽

Survival Rates ◽

Cardiac Anomalies ◽

Prenatal Counselling ◽

Associated Malformations ◽

Postnatal Outcome ◽

Congenitally Corrected Transposition ◽

Corrected Transposition

Abstract Purpose To analyze anatomic features and associated malformations in 37 prenatally detected cases of congenitally corrected transposition of the great arteries (ccTGA) and to evaluate the prenatal course, neonatal outcome and mid-term follow-up. Methods Retrospective analysis of prenatal ultrasound of 37 patients with ccTGA in two tertiary centers between 1999 and 2019. All fetuses received fetal echocardiography and a detailed anomaly scan. Postnatal outcome and follow-up data were retrieved from pediatric reports. Results Isolated ccTGA without associated cardiac anomalies was found in 13.5% (5/37), in all other fetuses additional defects such as VSD (73.0%), pulmonary obstruction (35.1%), tricuspid valve anomalies (18.9%), aortic arch anomalies (13.5%), ventricular hypoplasia (5.4%) or atrioventricular block (5.4%) were present. The rate of extracardiac malformations or chromosomal aberrations was low. There were 91.9% (34/37) live births and postnatal survival rates reached 91.2% in a mean follow-up time of 4.98 years. The prenatal diagnosis of ccTGA was confirmed postnatally in all but one documented live birth and the prenatal counselling regarding the expected treatment after birth (uni- versus biventricular repair) was reassured in the majority of cases. The postnatal intervention rate was high, 64.7% (22/34) received surgery, the intervention-free survival was 36.7%, 35.0% and 25.0% at 1 month, 1 year and 10 years, respectively. Conclusions ccTGA is a rare heart defect often associated with additional heterogeneous cardiac anomalies that can be diagnosed prenatally. The presented study demonstrates a favorable outcome in most cases but the majority of patients require surgical treatment early in life.

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Ultrasound Markers in Fetal Hydronephrosis to Predict Postnatal Surgery

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0591-3303 ◽

2018 ◽

Vol 41 (03) ◽

pp. 278-285 ◽

Cited By ~ 3

Author(s):

Teresa Antonia Kiener ◽

Christoph Wohlmuth ◽

Christa Schimke ◽

Martha Georgina Brandtner ◽

Dagmar Wertaschnigg

Keyword(s):

Prenatal Ultrasound ◽

Grading System ◽

Second Trimester ◽

Operating Characteristics ◽

Fetal Hydronephrosis ◽

Antenatal Hydronephrosis ◽

Outcome Group ◽

Postnatal Outcome ◽

Grade 3 ◽

Postnatal Surgery

Abstract Purpose Parents confronted with the finding of antenatal hydronephrosis (ANH) are particularly interested in whether their baby will need postnatal surgery. The objective of this study was to predict ANH requiring surgery on the basis of the fetal anteroposterior renal pelvic diameter (APRPD) and the Society for Fetal Urology (SFU) grading system. Materials and Methods The medical records of 179 patients with the finding of ANH were reviewed retrospectively. ANH was graded according to the SFU grading system. Prenatal ultrasound examinations were correlated to postnatal outcome, which was divided into three groups: prenatal resolution, conservative management and surgical treatment. Results 58 (32.4 %) cases were classified as prenatal resolution, 89 (49.7 %) babies were assigned to the conservative outcome group and 32 (17.9 %) patients needed surgical repair. Postnatal surgery was best predicted in the second trimester (area under the receiver operating characteristics curve: 0.839) by an APRPD cut-off of 8.3 mm (sensitivity: 77.8 %; specificity: 85.7 %; PPV of 53.9 %, NPV of 94.7 %). The combination of the parameters “progression of SFU grade” and SFU grade 3 or 4 achieved a sensitivity of 84.4 % and a specificity of 80.3 % for the prediction of surgery. Conclusion Second-trimester APRPD is a useful parameter for predicting the risk for postnatal surgery. The SFU grade should be assessed in every prenatal ultrasound examination as some further risk estimates can be made based on its dynamics over time.

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