In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 9 ( 2021-9-7), p. e0255890-
Abstract:
To determine whether bladder size is associated with an unfavorable neonatal outcome, in the case of first-trimester megacystis. Materials and methods This was a retrospective observational study between 2009 and 2019 in two prenatal diagnosis centers. The inclusion criterion was an enlarged bladder ( 〉 7 mm) diagnosed at the first ultrasound exam between 11 and 13 +6 weeks of gestation. The main study endpoint was neonatal outcome based on bladder size. An adverse outcome was defined by the completion of a medical termination of pregnancy, the occurrence of in utero fetal death, or a neonatal death. Neonatal survival was considered as a favorable outcome and was defined by a live birth, with or without normal renal function, and with a normal karyotype. Results Among 75 cases of first-trimester megacystis referred to prenatal diagnosis centers and included, there were 63 (84%) adverse outcomes and 12 (16%) live births. Fetuses with a bladder diameter of less than 12.5 mm may have a favorable outcome, with or without urological problems, with a high sensitivity (83.3%) and specificity (87.3%), area under the ROC curve = 0.93, 95% CI (0.86–0.99), p 〈 0.001. Fetal autopsy was performed in 52 (82.5%) cases of adverse outcome. In the 12 cases of favorable outcome, pediatric follow-up was normal and non-pathological in 8 (66.7%). Conclusion Bladder diameter appears to be a predictive marker for neonatal outcome. Fetuses with smaller megacystis (7–10 mm) have a significantly higher chance of progressing to a favorable outcome. Urethral stenosis and atresia are the main diagnoses made when first-trimester megacystis is observed. Karyotyping is important regardless of bladder diameter.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0255890
DOI:
10.1371/journal.pone.0255890.g001
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10.1371/journal.pone.0255890.g002
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10.1371/journal.pone.0255890.g003
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10.1371/journal.pone.0255890.t001
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10.1371/journal.pone.0255890.t002
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10.1371/journal.pone.0255890.t003
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10.1371/journal.pone.0255890.s001
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10.1371/journal.pone.0255890.s002
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10.1371/journal.pone.0255890.s003
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10.1371/journal.pone.0255890.s004
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10.1371/journal.pone.0255890.s005
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10.1371/journal.pone.0255890.r001
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10.1371/journal.pone.0255890.r002
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10.1371/journal.pone.0255890.r003
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10.1371/journal.pone.0255890.r004
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10.1371/journal.pone.0255890.r005
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10.1371/journal.pone.0255890.r006
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10.1371/journal.pone.0255890.r007
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10.1371/journal.pone.0255890.r008
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10.1371/journal.pone.0255890.r009
DOI:
10.1371/journal.pone.0255890.r010
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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