Prenatal Diagnosis of Fetal Bladder Outlet Obstruction at Songklanagarind Hospital: Report of 5 Casest
CHITKASAEM SUWANRA TH, M.D., M.Med.Sci. *, ROENGSAK LEETANAPORN, M.D.*, THITIMA SUNTHARASAJ, M.D.*, WINYOU MITARNUN, M.D.**
Affiliation : * Department of Obstetrics and Gynecology, ** Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand. t This paper was presented at the 14th Annual Scientific Meeting of the Royal Thai College of Obstetricians and Gynecologists, at the Royal Golden Jubilee Building, Bangkok, Thailand, on October 29, 1999.
Five cases of fetal bladder outlet obstruction prenatally diagnosed in the Perinatology Unit, Department of Obstetrics and Gynaecology, Songklanagarind Hospital, Songkhla, from January 1990 to September 1999 were reported. Ultrasound findings demonstrated megacystis, various degrees of hydroureter and hydronephrosis and oligohydramnios. Sex could be determined in only four cases and all were male. Chromosome abnormality (trisomy 18) was documented in one case. Postmortem results in three cases established that posterior urethral valves were the cause of obstruction. All cases in our series had poor outcome based on gestational age at first diag- nosis, sonographic findings, fetal urinalysis, and chromosome abnormality. Four cases underwent termination of pregnancy and the other resulted in a dead fetus in utero. The outcome of some cases may be improved by using the vesicoarnniotic shunt placement procedure that increases the likelihood of fetal survival. Therefore, the recommendation is to establish this procedure at Songkla- nagarind Hospital in the future.
Keywords : Bladder Outlet Obstruction, Lower Obstructive Uropathy, Prenatal Diagnosis, Ultra- sound
