Prenatal diagnosis of fetal bladder outlet obstruction at Songklanagarind Hospital: report of 5 cases.

ABSTRACT

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 diagnosis, 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 vesicoamniotic shunt placement procedure that increases the likelihood of fetal survival. Therefore, the recommendation is to establish this procedure at Songklanagarind Hospital in the future.