Category: Ultrasound/Imaging
Poster Session I
Objectives: To evaluate postnatal survival outcomes of severe LUTO-affected fetuses based on fetal bladder shape. We hypothesize that fetuses with a “floppy” appearing bladder on initial prenatal ultrasound will have worse neonatal outcomes than fetuses with full/rounded bladders.
Study Design:
Study
Design: We performed a retrospective case review of all cases of LUTO that were evaluated for fetal intervention in a single large fetal center between January 2013 and December 2021. Fetuses were given a “favorable” or “unfavorable” evaluation based on comprehensive ultrasound, renal biochemistry testing, and bladder refill testing. Favorable evaluations were offered fetal intervention with vesicoamniotic shunt placement. Baseline demographics, ultrasound parameters, prenatal renal function testing, and neonatal outcomes were collected. Those with a diagnosis of severe LUTO were included in analysis. Descriptive statistics were used to analyze candidate data. Primary outcome was survival at 6 months of life.
Results:
Results: Of the 104 LUTO patients evaluated, 24 were included in analysis. Details of prenatal evaluations are shown in Table 1a; six-month survival among groups based on fetal bladder morphology are shown in Table 1b. Postnatal survival at six months in patients with rounded bladders was 60% overall. Fetuses with floppy bladders showed a 0% six-month overall survival, which was significantly lower (p=0.002) as compared with the full/rounded bladder group.
Conclusion:
Conclusions: We propose that analysis of bladder shape in fetuses with severe LUTO may be an important prognostication factor for predicting neonatal outcomes. This simple, non-invasive assessment may inform clinical decision-making regarding further testing or fetal intervention.
Kara J. Shannon
Medical Student
Baylor College of Medicine
Houston, Texas, United States
Sarah VanLoh, N/A
Baylor College of Medicine
Houston, Texas, United States
Jimmy Espinoza, MD, MSc (he/him/his)
Professor
McGovern Medical School at the University of Texas Health Science Center Houston. The Fetal Center- Children’s Memorial Hermann Hospital
Houston, Texas, United States
Magda Sanz Cortes, MD, PhD (she/her/hers)
Associate Professor in the Department of Obstetrics and Gynecology, Baylor College of Medicine
Baylor College of Medicine
Houston, Texas, United States
roopali V. donepudi, MD
Assistant Professor
Baylor College of Medicine
Houston, Texas, United States
Alireza Shamshirsaz, MD
Department of Obstetrics & Gynecology, Division of Fetal Intervention, Baylor College of Medicine and Texas Children’s Hospital
Houston, Texas, United States
Chester Koh, MD
Texas Children's Hospital, Department of Urology
Houston, Texas, United States
David Roth, MD
Baylor College of Medicine
Houston, Texas, United States
Michael Braun, MD
Baylor College of Medicine
Houston, Texas, United States
Joseph Angelo, MD
Baylor College of Medicine
Houston, Texas, United States
Michael A. Belfort, MD,PhD (he/him/his)
Professor, Chairman
Baylor College of Medicine / Texas Children's Hospital
Houston, Texas, United States
Ahmed A. Nassr, MD, PhD
Associate professor
Baylor College of Medicine
Houston, Texas, United States