Capone, Valentina, Persico, Nicola, Berrettini, Alfredo, Decramer, Stephane, De Marco, Erika Adalgisa, De Palma, Diego, Familiari, Alessandra ORCID: 0000-0002-6353-9383, Feitz, Wout, Herthelius, Maria ORCID: 0000-0003-3306-2235, Kazlauskas, Vytis, Liebau, Max, Manzoni, Gianantonio, Maternik, Michal ORCID: 0000-0001-7292-0795, Mosiello, Giovanni, Schanstra, Joost Peter, Vande Walle, Johan, Wuhl, Elke, Ylinen, Elisa, Zurowska, Aleksandra, Schaefer, Franz and Montini, Giovanni ORCID: 0000-0002-7350-4475 (2022). Definition, diagnosis and management of fetal lower urinary tract obstruction: consensus of the ERKNet CAKUT-Obstructive Uropathy Work Group. Nat. Rev. Urol., 19 (5). S. 295 - 304. BERLIN: NATURE PORTFOLIO. ISSN 1759-4820

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Abstract

In this Consensus Statement, a focus group of experts in the field has detailed clinical evidence regarding the classification and current treatment of fetal lower urinary tract obstruction and provided recommendations for prenatal definition, diagnosis and management of this condition. Fetal lower urinary tract obstruction (LUTO) is associated with high mortality and postnatal morbidity caused by lung hypoplasia and impaired kidney function. Specific diagnostic features that can guide clinical approach and decisions are lacking; thus, the European Reference Network for Rare Kidney Diseases established a work group to develop recommendations regarding the clinical definition, diagnosis and management of prenatally detected LUTO. The work group recommends the use of antero-posterior diameter of renal pelvis as the most reliable parameter for suspecting obstructive uropathies and for suspecting prenatal LUTO in the presence of fetal megacystis. Regarding prenatal and postnatal prognosis of fetuses with LUTO, the risk of fetal and neonatal death depends on the presence of oligohydramnios or anhydramnios before 20 weeks' gestation, whereas the risk of kidney replacement therapy cannot be reliably foreseen before birth. Parents of fetuses with LUTO must be referred to a tertiary obstetric centre with multidisciplinary expertise in prenatal and postnatal management of obstructive uropathies, and vesico-amniotic shunt placement should be offered in selected instances, as it increases perinatal survival of fetuses with LUTO.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Capone, ValentinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Persico, NicolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berrettini, AlfredoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Decramer, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Marco, Erika AdalgisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Palma, DiegoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Familiari, AlessandraUNSPECIFIEDorcid.org/0000-0002-6353-9383UNSPECIFIED
Feitz, WoutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herthelius, MariaUNSPECIFIEDorcid.org/0000-0003-3306-2235UNSPECIFIED
Kazlauskas, VytisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebau, MaxUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Manzoni, GianantonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maternik, MichalUNSPECIFIEDorcid.org/0000-0001-7292-0795UNSPECIFIED
Mosiello, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schanstra, Joost PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vande Walle, JohanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wuhl, ElkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ylinen, ElisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zurowska, AleksandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montini, GiovanniUNSPECIFIEDorcid.org/0000-0002-7350-4475UNSPECIFIED
URN: urn:nbn:de:hbz:38-696318
DOI: 10.1038/s41585-022-00563-8
Journal or Publication Title: Nat. Rev. Urol.
Volume: 19
Number: 5
Page Range: S. 295 - 304
Date: 2022
Publisher: NATURE PORTFOLIO
Place of Publication: BERLIN
ISSN: 1759-4820
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
POSTNATAL RENAL-FUNCTION; SERUM BETA(2)-MICROGLOBULIN; OLIGOHYDRAMNIOS; INTERVENTION; ULTRASOUND; 2ND; BETA-2-MICROGLOBULIN; HYDRONEPHROSIS; CLASSIFICATION; PREGNANCIESMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69631

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