| Title: |
Megacystis in the first trimester of pregnancy: Prognostic factors and perinatal outcomes |
| Authors: |
Lesieur, Emmanuelle; Barrois, Mathilde; Bourdon, Mathilde; Blanc, Julie; Loeuillet, Laurence; Delteil, Clémence; Torrents, Julia; Bretelle, Florence; Grangé, Gilles; Tsatsaris, Vassilis; Anselem, Olivia |
| Contributors: |
Microbes Evolution Phylogénie et Infections (MEPHI); Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU) |
| Source: |
ISSN: 1932-6203. |
| Publisher Information: |
CCSD; Public Library of Science |
| Publication Year: |
2021 |
| Collection: |
Aix-Marseille Université: HAL |
| Subject Terms: |
Bladder; Pregnancy; Ultrasound imaging; Fetuses; Renal system; Fetal death; Pediatrics; Urology; [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology; [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases; [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases; [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology; [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology |
| Description: |
International audience ; Objective 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. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
PUBMEDCENTRAL: PMC8423287 |
| DOI: |
10.1371/journal.pone.0255890 |
| Availability: |
https://amu.hal.science/hal-03666153; https://amu.hal.science/hal-03666153v1/document; https://amu.hal.science/hal-03666153v1/file/pone.0255890.pdf; https://doi.org/10.1371/journal.pone.0255890 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.43DF983 |
| Database: |
BASE |