Prenatal diagnosis of urinary tract anomalies, a cohort study in the Northern Netherlands.

OBJECTIVE: To describe prevalence, time of diagnosis, and type of birth in children and fetuses with urinary tract (UT) anomalies after the introduction of the anomaly scan in the Netherlands in 2007. METHODS: We selected, from a population-based congenital anomaly registry, children and fetuses with UT anomalies born between 2008 and 2014. Cases were defined according to type of UT anomaly and whether isolated or with associated anomalies. Information was collected on time of diagnosis and type of birth. RESULTS: We included 487 cases. Total prevalence increased from 34.0 in 2008 to 42.3 per 10 000 births in 2014, mainly by an increase in anomalies of the collecting system. Almost 70% presented as isolated. Anomalies of the renal parenchyma were more often associated with genetic or other anomalies (47.3%) than anomalies of the collecting system (19.0%). The proportion of prenatally diagnosed cases increased from 59.3% in 2008 to 80.9% in 2014. Termination of pregnancy occurred in 14.8%, of which the majority were UT anomalies associated with a genetic disorder or other anomalies. CONCLUSION: In the period after the introduction of the anomaly scan, we observed an increasing prevalence of anomalies of the collecting system, but no increase in termination of pregnancies.

Prevalence, timing of diagnosis and pregnancy outcome of abdominal wall defects after the introduction of a national prenatal screening program.

OBJECTIVE: To examine prevalence, time of diagnosis and outcome of fetuses with an exomphalos or gastroschisis, diagnosed since the introduction of a national prenatal screening program in 2007. METHODS: A prospective cohort study was undertaken in two fetal medicine units in the Netherlands. Cases were included if the estimated due date was between 2009 and 2013. Outcome measures were gestational age at diagnosis, presence of additional anomalies and pregnancy outcome. RESULTS: A total of 141 exomphalos and 44 gastroschisis cases were included in the study, of which, respectively, 96 and 95% were diagnosed prenatally. The majority of the cases are visualized prior to the 20-week scan. In the exomphalos group, 83% had additional anomalies of which 57% had a chromosomal anomaly. Additional anomalies were present in 11% of the gastroschisis cases of which 40% had a chromosomal anomaly. The pregnancy termination rate was 61% (exomphalos) and 14% (gastroschisis). CONCLUSION: Almost all exomphalos and gastroschisis cases are diagnosed prenatally, the majority in the first trimester. Associated anomalies are far more common in exomphalos with a fourfold lower survival rate than gastroschisis. In the exomphalos group, the pregnancy termination rate doubled, while in the gastroschisis group the rate remained low. © 2017 John Wiley & Sons, Ltd.