Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?
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Ambra Iuculano
Abstract
Objective:
To evaluate the best management of fetal megacystis diagnosed in the first trimester and define the prognosis and the most appropriate follow-up as early as possible.
Methods:
This is a retrospective study of first-trimester fetal megacystis diagnosed in pregnant women who performed a combined screening for fetal aneuploidy. Megacystis was defined as a longitudinal bladder diameter (LBD) greater than 7 mm. All fetuses were divided into two groups according to the LBD: Group A with LBD > 15 mm and Group B with LBD < 15 mm. The fetal karyotype and associated anomalies were evaluated. Ultrasound monitoring was performed every 2 weeks (a second ultrasound scan after 2 weeks from diagnosis and a third ultrasound scan 2 weeks after the second one).
Results:
Twenty-six cases were identified between 2011 and 2016; three cases of aneuploidy were excluded from the study. Of the remaining 23 cases, 11 were included in Group A and 12 in Group B. All Group A fetuses had an adverse outcome. In Group B: five (41.7%) cases had an adverse outcome and seven (58.3%) had a spontaneous resolution of megacystis. The ultrasound findings of both the ultrasound scans, the second and the third, were 100% concordant.
Conclusion:
An ultrasound scan performed 2 weeks after the megacystis diagnosis can predict the outcome in fetuses with an LBD < 15 mm as early as the end of the first trimester. The outcome of euploid fetuses with an LBD < 15 mm was favorable in 58.3% of the cases.
Acknowledgments
The authors thank Boyana Petrova Tsikalova for editorial and linguistic assistance.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Fetal anomalies – From prenatal diagnosis to therapy
- Corner of Academy
- The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications
- Research articles – Obstetrics
- Assessment of strain and dyssynchrony in normal fetuses using speckle tracking echocardiography – comparison of three different ultrasound probes
- Inborn errors of metabolism in a cohort of pregnancies with non-immune hydrops fetalis: a single center experience
- Cytogenetic analysis in fetuses with late onset abnormal sonographic findings
- Fetal MRI, lower acceptance by women in research vs. clinical setting
- Neurological complications after therapy for fetal-fetal transfusion syndrome: a systematic review of the outcomes at 24 months
- Evaluation of management and surgical outcomes in pregnancies complicated by acute cholecystitis
- Pentaerythrityltetranitrate (PETN) improves utero- and feto-placental Doppler parameters in pregnancies with impaired utero-placental perfusion in mid-gestation – a secondary analysis of the PETN-pilot trial
- Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study
- Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multicenter study
- Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study
- Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?
- Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?
- Research articles – Fetus
- A poor long-term neurological prognosis is associated with abnormal cord insertion in severe growth-restricted fetuses
- Birth-weight centiles and the risk of serious adverse neonatal outcomes at term
- Short communication
- Maternal and neonatal vitamin D deficiency and transient tachypnea of the newborn in full term neonates
- Acknowledgment
Articles in the same Issue
- Frontmatter
- Editorial
- Fetal anomalies – From prenatal diagnosis to therapy
- Corner of Academy
- The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications
- Research articles – Obstetrics
- Assessment of strain and dyssynchrony in normal fetuses using speckle tracking echocardiography – comparison of three different ultrasound probes
- Inborn errors of metabolism in a cohort of pregnancies with non-immune hydrops fetalis: a single center experience
- Cytogenetic analysis in fetuses with late onset abnormal sonographic findings
- Fetal MRI, lower acceptance by women in research vs. clinical setting
- Neurological complications after therapy for fetal-fetal transfusion syndrome: a systematic review of the outcomes at 24 months
- Evaluation of management and surgical outcomes in pregnancies complicated by acute cholecystitis
- Pentaerythrityltetranitrate (PETN) improves utero- and feto-placental Doppler parameters in pregnancies with impaired utero-placental perfusion in mid-gestation – a secondary analysis of the PETN-pilot trial
- Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study
- Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multicenter study
- Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study
- Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?
- Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?
- Research articles – Fetus
- A poor long-term neurological prognosis is associated with abnormal cord insertion in severe growth-restricted fetuses
- Birth-weight centiles and the risk of serious adverse neonatal outcomes at term
- Short communication
- Maternal and neonatal vitamin D deficiency and transient tachypnea of the newborn in full term neonates
- Acknowledgment
