Fetal lower urinary tract obstruction: What should we tell the prospective parents?

Prenat Diagn. 2020 May;40(6):661-668. doi: 10.1002/pd.5669. Epub 2020 Feb 26.

Abstract

Fetal lower urinary tract obstruction (LUTO), which often results in marked perinatal morbidity and mortality, is caused by a heterogeneous group of anatomical defects that lead to blockage of the urethra. The classic prenatal presentation of LUTO includes megacystis with hydronephrosis. While mild forms of the disease can be associated with favorable outcomes, more severe disease commonly leads to dysplastic changes in the fetal kidneys, and ultimately oligohydramnios, which can result in secondary pulmonary hypoplasia and renal failure at birth. The aim of this review is to provide practitioners with a general overview of the diagnosis and treatment of LUTO based on disease severity, along with some points to consider when counseling prospective parents of fetuses with this condition.

Publication types

  • Review

MeSH terms

  • Abnormalities, Multiple / diagnostic imaging
  • Abnormalities, Multiple / etiology
  • Counseling
  • Female
  • Fetal Therapies
  • Humans
  • Kidney / abnormalities
  • Kidney / diagnostic imaging*
  • Lung / abnormalities
  • Lung / diagnostic imaging
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / etiology
  • Male
  • Oligohydramnios / diagnostic imaging*
  • Oligohydramnios / etiology
  • Oligohydramnios / therapy
  • Pregnancy
  • Prenatal Care
  • Prenatal Diagnosis
  • Severity of Illness Index
  • Ultrasonography, Prenatal
  • Urethra / abnormalities
  • Urethra / diagnostic imaging*
  • Urethral Obstruction / diagnostic imaging*
  • Urethral Obstruction / surgery
  • Urethral Obstruction / urine
  • Urinary Bladder / abnormalities
  • Urinary Bladder / diagnostic imaging*

Supplementary concepts

  • Lung agenesis