Prénatal diagnosis of uropathies: A review of 10 cases

Obstructive uropathies are a frequent cause of child renal failure. The prenatal diagnosis of such abnomalies should lead to appropriate managemeni. Objective: to evaluate the interest of ultrasonographic prenatal diagnosis of urinary tract malformations Patients and methods : retropective study of 10 cases of urinary tract malformations diagnosed in utero. The mean age of the patients was 34,9 years and the mean gestationnal age at the prenatal diagnosis was 28,2 weeks of amenorrhea. The abnormalties diagnosed were : 2 cases of ureteropelvic junction obstruction, 3 cases of posterior urethral valves and 5 cases of mild hydronephrosis. The fetal karyotype, realised in 8 cases, was normal. In one case the urinary abnormaltie was part of a multiple malformation syndrome and led to the termination of the pregnancy. 7 cases had a postnatal follow-up: 5 had a surgical management and two new borns had transient pyelectasies . The prediction of postnatal renal function is made by ultrasonographic appearence of the kidney and the amniotic fluid. Although the analysis of fetal urine for the assesment of renal function leads to conflicting results, it seems that sodium and beta-2 microglobulin urinary rates provide useful informations.