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Fetal obstructive uropathy: is urine sampling useful for prenatal counselling?

2005; Wiley; Volume: 26; Issue: 1 Linguagem: Inglês

10.1002/pd.1360

1097-0223

Javier Miguelez, Victor Bunduki, Carlos Tadashi Yoshizaki, Lilian dos Santos Rodrigues Sadek, Vera Hermina Kalika Koch, Cleisson Fábio Andrioli Peralta, Marcelo Zugaib,

Pregnancy and preeclampsia studies

Objectives To evaluate whether fetal urinary sodium and chloride provide clinically useful information in addition to ultrasound in bilateral obstructive uropathy. Methods Sonographic features and urinary concentrations of sodium and chloride were evaluated in fetuses with bilateral obstructive uropathy. After a minimum of 12 months of postnatal follow-up, cases that developed increased serum creatinine (greater than 50 µmol/L) were compared with those that did not. Results Of the cases studied, 16/35 died perinatally, all showing anamnios and markedly elevated urinary electrolytes. Of the survivors, ten maintained normal postnatal serum creatinine, whereas nine did not. The frequency of reduced amniotic fluid/olygohydramnios was higher in cases that developed increased serum creatinine (four out of nine) than in those that did not (nil). Sodium above the 95th percentile was 100% specific and 44% sensitive to predict an increased serum creatinine during early infancy, while chloride above the 95th percentile was 70% specific and 56% sensitive. All seven cases in which urinary sodium was elevated and/or amniotic fluid volume was reduced developed renal failure. Conclusion Urine sampling slightly improved renal function prediction, but this must be balanced against its fetal risks. Copyright © 2006 John Wiley & Sons, Ltd.