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19–22 APRIL, 2017, BARCELONA, SPAIN
16:06–16:09
S18-3 (PP)
PRENATAL URINARY TRACT ANOMALIES LEADING
TO TERMINATION OF PREGNANCY
Guy VERHOVSKY
Assaf Harofeh Medical Center, Urology, , Zerifin, ISRAEL
PURPOSE
To assess the characteristics of prenatal diagnosis of fetal urinary tract anomalies (UTA) leading to
termination of pregnancy (TOP).
MATERIAL AND METHODS
A retrospective study of TOP after the second trimester screening between January 1998 to April
2015
Cases were divided into two groups:
Group 1 - Solitary UTA leading to TOP
Group 2 - multiple anatomical anomalies including UTA.
The cut-off at 24TH week of gestation was used to define early versus late abortion
RESULTS
There were 2789 cases of TOP. 1557 (50%) due to anatomic anomalies. UTA was diagnosed in
188 (12%) cases.
Group 1 - 97 (52%) - The major anomalies were urinary outlet obstruction (30%), bilateral renal
agenesis (19%).
From this group 94% had severe UTA defined as an abnormality incompatible with life or cause
severe negative impact on quality of life.
Group 2 - 91 (49%) the most prevalent UTA was Hydronephrosis.
Mean gestational age at TOP was 20.3±4.5 weeks in group 1 and 19.07±3.12 weeks in
group 2 (p=0.07).
Out of 1557 cases undergoing TOP, 80% of those with UTA underwent early TOP and 20% late TOP
compared to those who underwent TOP due to anatomic abnormalities other than UTA 89% early
TOP and 11% late. (P=0.012).
The reason for “late” abortion in group 1 in most of the cases were clinical deterioration during follow
up, 2 cases weren’t diagnosed in the early screening.
The main causes of early abortion were bilateral renal agenesis (35%) and bladder outlet obstruc-
tion (39%) whereas in the late abortions MCDK and AR-PCKD.
CONCLUSIONS
UTA composes 12% of all anatomic non-chromosomal TOP. Bladder outlet obstruction and bilateral
renal agenesis are the most prevalent causes diagnosed in second trimester US screening.
The percentage of late abortions is relatively high and should be reduced by advising strict monitor-
ing aiming for early detection.