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• W2008906212 abstract "No AccessJournal of UrologyPEDIATRIC UROLOGY1 May 2001IMPLICATIONS OF PRENATAL ULTRASOUND SCREENING IN THE INCIDENCE OF MAJOR GENITOURINARY MALFORMATIONS WILLIAM J. CROMIE, KWANG LEE, KARA HOUDE, and LEWIS HOLMES WILLIAM J. CROMIEWILLIAM J. CROMIE Financial interest and/or other relationship with Rhone Poulenc Rohrer. More articles by this author , KWANG LEEKWANG LEE More articles by this author , KARA HOUDEKARA HOUDE More articles by this author , and LEWIS HOLMESLEWIS HOLMES More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66391-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: During the last 3 decades infant mortality has decreased nearly 50%. While neonatal intensive care deserves much of the credit, the recent increase in prenatal ultrasound from 33% of pregnancies in 1980 to 78% in 1987 has improved early detection. We evaluate the impact of prenatal ultrasound on major genitourinary malformations. Materials and Methods: Data obtained from the Malformations Surveillance Program at Brigham and Women’s Hospital between 1974 and 1994 tracked 163,431 pregnancies and termination rates of fetuses with spina bifida, bladder exstrophy, the prune belly syndrome and posterior urethral valves. Results: Hospital data revealed that pregnancy was electively terminated due to spina bifida in 65% of cases, posterior urethral valves in 46%, the prune belly syndrome in 31% and exstrophy in 25%. Conclusions: Clearly, surveillance programs and improved accuracy of prenatal ultrasound have allowed early diagnosis of major genitourinary malformations. Many factors influence decision making in these affected fetal cases, including the financial and emotional impact of these major anomalies during lifetime. Future societal decisions and reduction in these anomalies may influence our training programs, manpower needs, medical facility requirements and character of our practices. These findings may have significant implications in the field of pediatric urology. References 1 : Effect of prenatal ultrasound screening on perinatal outcome. N Engl J Med1993; 329: 821. Google Scholar 2 : Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial, Lancet1990; 336: 387. Google Scholar 3 : Malformations due to presumed spontaneous mutations in newborn infants. N Engl J Med1989; 320: 19. Google Scholar 4 : a communication from the International Clearinghouse for Birth Defects. Teratology1987; 36: 221. Google Scholar 5 : Infant Mortality—United States, 1993. JAMA1996; 275: 980. Google Scholar 6 : Impact of the detection and prevention of developmental abnormalities in human studies. Reprod Toxicol1997; 11: 267. Google Scholar 7 : Down syndrome: increased prenatal detection and dramatic decrease in livebirth. Teratology1994; 49: 376. Google Scholar 8 : Hypoplastic left heart syndrome: effects of fetal echocardiography on birth prevalence. Lancet1991; 337: 959. Google Scholar 9 : Prevalence of neural tube defects in South Australia, 1996–1991-effectiveness and impact of prenatal diagnosis. BMJ1993; 307: 703. Google Scholar 10 Economic costs of birth defects and cerebral palsy—United States, 1992. MMWR Morb Mortal Wkly Rep1995; 44: 694. Google Scholar 11 Ransley, P. Personal Communication Google Scholar 12 : Complete primary closure of bladder exstrophy. Epispadias and bladder exstrophy repair. Urol Clin North Am1999; 26: 95. Google Scholar From the Department of Surgery, Section of Urology and Department of Pediatrics, Section of Neonatology, University of Chicago, Chicago, Illinois, and the Genetics and Teratology Unit, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLloyd J, Wiener J, Gargollo P, Inman B, Ross S and Routh J (2013) Contemporary Epidemiological Trends in Complex Congenital Genitourinary AnomaliesJournal of Urology, VOL. 190, NO. 4S, (1590-1595), Online publication date: 1-Oct-2013.EVANGELIDIS A, MURPHY J and GATTI J (2018) PRENATAL DIAGNOSIS OF BLADDER EXSTROPHY BY 3-DIMENSIONAL ULTRASOUNDJournal of Urology, VOL. 172, NO. 3, (1111-1111), Online publication date: 1-Sep-2004. Volume 165Issue 5May 2001Page: 1677-1680 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordspediatricsultrasonography, prenatalurogenital systemMetricsAuthor Information WILLIAM J. CROMIE Financial interest and/or other relationship with Rhone Poulenc Rohrer. More articles by this author KWANG LEE More articles by this author KARA HOUDE More articles by this author LEWIS HOLMES More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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