Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes.
<h4>Objective</h4>To determine whether bladder size is associated with an unfavorable neonatal outcome, in the case of first-trimester megacystis.<h4>Materials and methods</h4>This was a retrospective observational study between 2009 and 2019 in two prenatal diagnosis centers...
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2021
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oai:doaj.org-article:7089471d2b3c455da81f01b5d3452ba62021-12-02T20:04:43ZMegacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes.1932-620310.1371/journal.pone.0255890https://doaj.org/article/7089471d2b3c455da81f01b5d3452ba62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255890https://doaj.org/toc/1932-6203<h4>Objective</h4>To determine whether bladder size is associated with an unfavorable neonatal outcome, in the case of first-trimester megacystis.<h4>Materials and methods</h4>This was a retrospective observational study between 2009 and 2019 in two prenatal diagnosis centers. The inclusion criterion was an enlarged bladder (> 7 mm) diagnosed at the first ultrasound exam between 11 and 13+6 weeks of gestation. The main study endpoint was neonatal outcome based on bladder size. An adverse outcome was defined by the completion of a medical termination of pregnancy, the occurrence of in utero fetal death, or a neonatal death. Neonatal survival was considered as a favorable outcome and was defined by a live birth, with or without normal renal function, and with a normal karyotype.<h4>Results</h4>Among 75 cases of first-trimester megacystis referred to prenatal diagnosis centers and included, there were 63 (84%) adverse outcomes and 12 (16%) live births. Fetuses with a bladder diameter of less than 12.5 mm may have a favorable outcome, with or without urological problems, with a high sensitivity (83.3%) and specificity (87.3%), area under the ROC curve = 0.93, 95% CI (0.86-0.99), p< 0.001. Fetal autopsy was performed in 52 (82.5%) cases of adverse outcome. In the 12 cases of favorable outcome, pediatric follow-up was normal and non-pathological in 8 (66.7%).<h4>Conclusion</h4>Bladder diameter appears to be a predictive marker for neonatal outcome. Fetuses with smaller megacystis (7-10 mm) have a significantly higher chance of progressing to a favorable outcome. Urethral stenosis and atresia are the main diagnoses made when first-trimester megacystis is observed. Karyotyping is important regardless of bladder diameter.Emmanuelle LesieurMathilde BarroisMathilde BourdonJulie BlancLaurence LoeuilletClémence DelteilJulia TorrentsFlorence BretelleGilles GrangéVassilis TsatsarisOlivia AnselemPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0255890 (2021) |
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Medicine R Science Q Emmanuelle Lesieur Mathilde Barrois Mathilde Bourdon Julie Blanc Laurence Loeuillet Clémence Delteil Julia Torrents Florence Bretelle Gilles Grangé Vassilis Tsatsaris Olivia Anselem Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| description |
<h4>Objective</h4>To determine whether bladder size is associated with an unfavorable neonatal outcome, in the case of first-trimester megacystis.<h4>Materials and methods</h4>This was a retrospective observational study between 2009 and 2019 in two prenatal diagnosis centers. The inclusion criterion was an enlarged bladder (> 7 mm) diagnosed at the first ultrasound exam between 11 and 13+6 weeks of gestation. The main study endpoint was neonatal outcome based on bladder size. An adverse outcome was defined by the completion of a medical termination of pregnancy, the occurrence of in utero fetal death, or a neonatal death. Neonatal survival was considered as a favorable outcome and was defined by a live birth, with or without normal renal function, and with a normal karyotype.<h4>Results</h4>Among 75 cases of first-trimester megacystis referred to prenatal diagnosis centers and included, there were 63 (84%) adverse outcomes and 12 (16%) live births. Fetuses with a bladder diameter of less than 12.5 mm may have a favorable outcome, with or without urological problems, with a high sensitivity (83.3%) and specificity (87.3%), area under the ROC curve = 0.93, 95% CI (0.86-0.99), p< 0.001. Fetal autopsy was performed in 52 (82.5%) cases of adverse outcome. In the 12 cases of favorable outcome, pediatric follow-up was normal and non-pathological in 8 (66.7%).<h4>Conclusion</h4>Bladder diameter appears to be a predictive marker for neonatal outcome. Fetuses with smaller megacystis (7-10 mm) have a significantly higher chance of progressing to a favorable outcome. Urethral stenosis and atresia are the main diagnoses made when first-trimester megacystis is observed. Karyotyping is important regardless of bladder diameter. |
| format |
article |
| author |
Emmanuelle Lesieur Mathilde Barrois Mathilde Bourdon Julie Blanc Laurence Loeuillet Clémence Delteil Julia Torrents Florence Bretelle Gilles Grangé Vassilis Tsatsaris Olivia Anselem |
| author_facet |
Emmanuelle Lesieur Mathilde Barrois Mathilde Bourdon Julie Blanc Laurence Loeuillet Clémence Delteil Julia Torrents Florence Bretelle Gilles Grangé Vassilis Tsatsaris Olivia Anselem |
| author_sort |
Emmanuelle Lesieur |
| title |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| title_short |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| title_full |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| title_fullStr |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| title_full_unstemmed |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes. |
| title_sort |
megacystis in the first trimester of pregnancy: prognostic factors and perinatal outcomes. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/7089471d2b3c455da81f01b5d3452ba6 |
| work_keys_str_mv |
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