Ultrasound evaluation of prognosis in fetuses with posterior urethral valves Lisandra Stein Bernardes a,b, ⁎ , Remi Salomon c , Gunnar Aksnes d , Stephen Lortat-Jacob d , Alexandra Benachi a a Maternité. Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, France b Hospital das Clinicas da faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil – Departamento de Obstetrícia e Ginecologia c Service de néphrologie pédiatrique. Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, France d Service de chirurgie pédiatrique. Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, France Received 10 September 2010; revised 30 November 2010; accepted 10 December 2010 Key words: Posterior urethral valves; Prenatal; Ultrasound; Renal function Abstract Purpose: The aim of this study was to evaluate the ability of prenatal ultrasound markers to predict postnatal renal prognosis in fetuses with posterior urethral valves. Methods: Medical files on fetuses with prenatal diagnosis of posterior urethral valves from 2000 to 2006 were reviewed retrospectively. Data from prenatal follow-up included gestational age at diagnosis, ultrasound renal parenchyma evaluation, and presence and time of oligohydramnios onset. Prenatal parameters studied were correlated to postnatal renal function. Results: Thirty-one male fetuses were included. Six pregnancies were terminated. Of the remaining 25 pregnancies that were continued, 4 children had abnormal creatine and 21 normal creatinine levels at follow-up. Presence and time of oligohydramnios onset did not differ between groups (P = .43). Ultrasound detected bilateral renal abnormalities in 3 fetuses (75%) with altered renal function, and 10 fetuses (55%) with normal creatinine, at follow-up. Conclusions: None of the ultrasound parameters evaluated were able to reliably predict postnatal renal function. © 2011 Elsevier Inc. All rights reserved. 1. Background Posterior urethral valves (PUV) are the main cause of end-stage renal failure in male children [1-4]. In cases with prenatal suspicion of PUV, ultrasound assessment of prognosis is important to guide parents' counseling and indicate invasive evaluation of renal function [5-10]. Furthermore, if intrauterine procedures such as vesicoam- niotic shunts are considered, the evaluation of renal function may help to adequately select patients eligible for the procedure [11]. Several ultrasound parameters have been proposed as predictors of long-term renal function, such as amniotic fluid index and renal parenchyma evaluation [6,8,12-22]. However, previous studies have ⁎ Corresponding author. Divisão de Obstetrícia e Ginecologia do Hospital das Clínicas da Universidade de São Paulo Av. Dr Enéas de Carvalho Aguiar, 255- Cerqueira César- 05403-000 / São Paulo- Brasil. Tel.: +55 11 30 69 62 09; fax: +55 11 30 69 62 09. E-mail address: lisbernardes@usp.br (L. Stein Bernardes). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2011 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2010.12.010 Journal of Pediatric Surgery (2011) 46, 1412–1418