Bornes Marie, Spaggiari Emmanuel, Schmitz Thomas, Dreux Sophie, Czerkiewicz Isabelle, Delezoide Anne-Lise, El-Ghoneimi Alaa, Oury Jean-François, Muller Françoise
Gynecology and Obstetrics, AP-HP, Robert Debré Hospital, Paris, France; Gynecology and Obstetrics, AP-HP, Tenon Hospital, Paris, France.
Prenat Diagn. 2013 Dec;33(12):1162-6. doi: 10.1002/pd.4215. Epub 2013 Sep 3.
To investigate the gestational age-specific outcomes and the different etiologies of megacystis diagnosed at screening ultrasound.
A retrospective single-center study was conducted between 1989 and 2009. We identified all consecutive cases of megacystis prenatally diagnosed during routine ultrasound screening. Outcome, final diagnosis, and renal function were recorded.
Eighty-four patients were included. An isolated lower urinary tract obstruction was observed in 38/84 (45.2%), ureterovesical reflux in 9/84 (10.7%), an associated congenital abnormality in 32/84 (38.1%) and a normal bladder in 5/84 (6%). Increased gestational age at diagnosis was correlated with an increased rate of live born children (P < 0.01). No cases of megacystis diagnosed in the first trimester were born alive. When diagnosis of posterior urethral valves (PUV) was made in the third trimester, the ultimate survival rate was 11/13 (84.6%) compared with 3/12 (25%) for a diagnosis made in the second trimester (P = 0.02).
Lower urinary tract obstruction is the main etiology of megacystis. Megacystis can also be part of more complex malformations. Outcome of megacystis detected in the first trimester is poor. PUV detected in the third trimester had a better overall survival rate than PUV detected in the second trimester.
探讨孕龄特异性结局以及筛查超声诊断出的巨大膀胱的不同病因。
1989年至2009年间进行了一项回顾性单中心研究。我们确定了所有在常规超声筛查期间产前诊断出的连续巨大膀胱病例。记录结局、最终诊断和肾功能。
纳入84例患者。84例中有38例（45.2%）观察到孤立性下尿路梗阻，9例（10.7%）有输尿管膀胱反流，32例（38.1%）有相关先天性异常，5例（6%）膀胱正常。诊断时孕周增加与活产儿比例增加相关（P<0.01）。孕早期诊断出的巨大膀胱病例无活产。孕晚期诊断为后尿道瓣膜（PUV）时，最终存活率为11/13（84.6%），而孕中期诊断时为3/12（25%）（P = 0.02）。
下尿路梗阻是巨大膀胱的主要病因。巨大膀胱也可能是更复杂畸形的一部分。孕早期检测到的巨大膀胱结局较差。孕晚期检测到的PUV总体存活率高于孕中期检测到的PUV。
