Results Lower Urinary Tract Obstruction (LUTO)įetal LUTO refers to the combination of bilateral hydroureteronephrosis and a persistently distended bladder ( 2). Older articles were included if considered important. Articles from the last 10 years were preferentially included for this review. Literature review searching PubMed, Cochrane, and Embase databases using pertinent key words for each subject of this review. Here we briefly summarize the current literature regarding prenatal management of fetal lower urinary obstruction, hydronephrosis, hydrocolpos, congenital adrenal hyperplasia, and myelomeningocele. Nevertheless, prenatal treatment of many conditions diagnosed prenatally remains controversial. In addition, fetal genetic testing has allowed the prenatal diagnosis of many diseases, among them congenital adrenal hyperplasia (CAH) the prenatal treatment of which impacts postnatal management and outcome. Significant technical improvements in ultrasonography (US) technology and the addition of fetal MRI have led to significant refinements in prenatal diagnosis. Prenatal detection of genito-urinary tract anomalies has been possible for about 50 years and prenatal surgical interventions for lower urinary tract obstruction (LUTO) date back to the 1980s ( 1). The purpose of this minireview is to present current knowledge of the effectiveness and impact of prenatal intervention in fetuses with congenital anomalies which have urological consequences in postnatal life. Prospective studies including standardized urologic evaluation will determine if the encouraging results reported by some hold on the long term follow-up. Fetal treatment of myelomeningocele (MMC) is gaining momentum. Non-invasive fetal DNA analysis allows earlier diagnosis, reducing the risk of treating with dexamethasone males and non-affected fetuses.ģ. Prenatal treatment of female fetuses at risk of having congenital adrenal hyperplasia (CAH) reduces virilization. Prenatal intervention in lower urinary tract obstruction (LUTO) improves survival in the worst cases by improving pulmonary function and it may be advantageous for renal function, particularly in patients with adverse urine parameters.Ģ. In this review, we reached the following conclusions:ġ. Despite several decades of fetal intervention for these conditions, benefits remain elusive in part because of the enormous difficulty of conducting prospective randomized studies. We reviewed the literature addressing outcomes of fetal intervention of conditions that require post-natal urological management including lower urinary tract obstruction, hydrometrocolpos, congenital adrenal hyperplasia, and myelomeningocele. 2Pediatric Surgery and Urology, Kinder- und Jugendkrankenhaus AUF DER BULT, Hanover, Germany.1Department of Urology, Charité Medical University of Berlin, Berlin, Germany.Beatiz Bañuelos Marco 1 Ricardo González 1,2 * Barbara Ludwikowski 2 Anja Lingnau 1
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