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PF.72 Posterior Urethral Valves: An Audit of Cases Presenting at a Fetal Medicine Department Serving South Wales
  1. LF Black1,
  2. RB Beattie2
  1. 1Cardiff University, Cardiff, UK
  2. 2University Hospital of UK, Cardiff, UK

Abstract

Introduction Posterior Urethral Valves (PUVs) are the most prevalent congenital anomaly causing bilateral renal impairment due to obstruction. Our audit intends to help us to improve renal counselling for patients with fetuses with PUVs.

Methods Scan details of fetuses with suspected PUVs were located and divided into multiple visits by the same woman. The clinical portal and Protus maternity databases were used to find to outcomes for the pregnancies. Descriptive statistics and Chi Square tests were used to analyse the data.

Results 267 scans recorded on the Fetal Medicine Department database since 2001 aroused suspicion of PUVs. There were 76 individual cases. Most (56.6%) fetuses had enlarged bladders. 31 (40.8%) fetuses had hydronephrosis. 15 (19.7%) women had oligohydramnios; 11 (14.5%) anhydramnios. 43 (56.6%) women were offered renal counselling.

We acquired some outcomes for 56 pregnancies. Outcomes were located for 42 fetuses. 7 pregnancies were terminated. Most (n = 31, 55.4%) babies were born vaginally unassisted. Most (n = 30, 73.2%) fetuses had no known none-genitourinary malformations, 8 (19.5%) had additional genitourinary anomalies. 71% of surviving children required renal paediatric follow-up; 35.5% had chronic renal failure. Amniotic fluid reduction was correlated with decreased survival. Vesicoamniotic shunts did not affect survival.

Discussion and Conclusions More women require specific renal counselling where PUV is suspected. Our findings reinforce the fact that oligohydramnios is correlated with negative outcomes (probably due to pulmonary hypoplasia), allowing better counselling for these women.

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