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Pränatale Diagnostik und Therapie urogenitaler Fehlbildungen

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Die Kinder- und Jugendurologie

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Zusammenfassung

Die Beurteilung der fetalen Nieren und der fetalen Harnblase gehört zur Routineuntersuchung im Rahmen des Ultraschallscreenings in der Schwangerenvorsorge. Die sonografische Beurteilung der fetalen Nieren umfasst neben der Biometrie der Nieren und des Nierenbeckens die Echogenität des Nierenparenchyms und die Form sowie die Lokalisation der Nieren. Die fetale Harnblase muss dargestellt und die Größe, Form und Lage in Zusammenschau mit der Fruchtwassermenge beurteilt werden. Harnwegsdilatationen sind die häufigsten Auffälligkeiten. Ihre Ursachen müssen individuell abgeklärt werden. Relevante Nieren- und Harnblasenfehlbildungen lassen sich in der Hand eines spezialisierten Pränatalmediziners mit einer hohen Verlässlichkeit diagnostizieren und einem interdisziplinären perinatologischem Management zuführen. Die Indikation fetalchirurgischer Interventionen sollte in interdisziplinärer Absprache und unter eingehender Beratung mit den Eltern streng indiziert werden. Hauptziele intrauteriner Eingriffe sind die Verhinderung einer schweren Nierenfunktionsstörung und die Prävention einer Lungenhypoplasie.

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Literatur

  • Abdennadher W, Chalouhi G, Dreux S et al (2015) Fetal urine biochemistry at 13–23 weeks of gestation in lower urinary tract obstruction: criteria for in-utero treatment. Ultrasound Obstet Gynecol 46:30–311

    Article  Google Scholar 

  • Agathokleous M, Chaveeva P, Poon LCY et al (2013) Metaanalysis of second-trimester markers for trisomy 21. Ultrasound Obstet Gynecol 41:247–261

    Article  CAS  PubMed  Google Scholar 

  • Al Naimi A, Baumueller JE, Bahlmann F (2013) Prenatal diagnosis of multicystic dysplastic kidney disease in the second trimester screening. Prenat Diagn 33:726–731

    Article  PubMed  Google Scholar 

  • AWMF-Leitlinie (2020): Nierenzysten und zystische Nierenerkrankungen bei Kindern. S2k. AWMF-Registernummer: 166-003

    Google Scholar 

  • Bergmann C, Senderek J, Schneider F et al (2004) PKHD1 mutations in families requesting prenatal diagnosis for autosomal-rezessive polycystic kidney disease (ARPKD). Hum Mutat 23:487–495

    Article  CAS  PubMed  Google Scholar 

  • Brace RA (1997) Physiology of amniotic fluid volume regulation. Clin Obstet Gynecol 40:280–289

    Article  CAS  PubMed  Google Scholar 

  • Burgmaier K, Kunzmann K, Ariceta G et al (2018) Risk factors for early dialysis dependency in autosomal recessive polycystic kidney disease. J Pediatr 199:22–28.e6

    Article  PubMed  Google Scholar 

  • Cheung KW, Morris RK, Kilby MD (2019) Congenital urinary tract obstruction. Best Prac Res Clin Obstet Gynaecol 58:78–92

    Article  Google Scholar 

  • Chitty LS, Altman DG (2003) Charts of fetal size: kidney and renal pelvis measurements. Prenat 23:891–897

    Article  Google Scholar 

  • Christianson C, Huff D, Mc Pherson E (1999) Limb deformations in oligohydamnios sequence: effect of gestational age and duration of oligohydramnios. Am J Med Genet 86:430–433

    Article  CAS  PubMed  Google Scholar 

  • Chudleigh T (2001) Mild pyelectasis. Prenat Diagn 21:936–941

    Article  CAS  PubMed  Google Scholar 

  • Corteville JE, Gray DL, Crane JP (1991) Congenital hydronephrosis: correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 165:384–388

    Article  CAS  PubMed  Google Scholar 

  • Dreux S, Rosenblatt J, Moussy-Durandy A et al (2018) Urine biochemistry to predict long-term outcomes in fetuses with posterior urethral valves. Prenat Diagn 38:964–970

    Article  CAS  PubMed  Google Scholar 

  • Fägerquist M, Fägerquist U, Oden A et al (2001) Fetal urine production and accuracy when estimating fetal urinary bladder volume. Ultrasound Obstet Gynecol 17:132–139

    Article  PubMed  Google Scholar 

  • Fernbach SK, Maizels M, Conway JJ (1993) Ultrasound grading of hydronephrosis: Introduction to the system used by the society of fetal urology. Pediatr Radiol 23:478–480

    Article  CAS  PubMed  Google Scholar 

  • Fu F, Chen F, Li R et al (2016) Prenatal diagnosis of fetal multicystic dysplastic kidney via high-resolution whole-genome array. Nephrol Dial Transplant 31:1693–1698

    Article  CAS  PubMed  Google Scholar 

  • Gembruch U (2018) Niere und Urogenitaltrakt. In: Gembruch U, Steiner H, Hecher K (Hrsg) Ultraschalldiagnostik in Geburtshilfe und Gynäkologie, 2. Aufl. Springer, Heidelberg, S 295–358

    Chapter  Google Scholar 

  • Grandjean D, Larroque D, Levi S (1999) The performance of routine ultrasonographic screening of pregnancies in the Eurofetus study. Am J Obsteet Gynecol 181:446–454

    Article  CAS  Google Scholar 

  • Ismaili K, Hall M, Piepsz A et al (2005) Insights into the pathogenesis and natural history of fetuses with renal pelvis dilatation. Eur Urol 48:207–214

    Article  PubMed  Google Scholar 

  • Kurtz MP, Koh CJ, Jamail GA et al (2016) Factors associated with fetal shunt dislodgement in lower urinary tract obstruction. Prenat Diagn 36:720–725

    Article  PubMed  Google Scholar 

  • Lee RS, Cendron M, Kinnamon DD et al (2006) Antenatal hydronephrosis as a predictor of postnatal outcome: a metaanalysis. Pediatrics 118:586–593

    Article  PubMed  Google Scholar 

  • Malin G, Tonks AM, Morris RK et al (2012) Congenital lower urinary tract obstruction: a population-based epidemiological study. BJOG 119:1455–1564

    Article  CAS  PubMed  Google Scholar 

  • Moore TR (1997) Clinical assessment of amniotic fluid. Clin Obstet Gynecol 40:303–313

    Article  CAS  PubMed  Google Scholar 

  • Morris RK, Quinlan-Jones E, Kilby MD et al (2007) Systematic review of accuracy of fetal urine analysis to predict poor postnatal renal function in cases of congenital urinary tract obstruction. Prenat Diagn 27:900–911

    Article  CAS  PubMed  Google Scholar 

  • Morris RK et al (2012) Congenital lower urinary tract obstruction: a population-based epidemiological study. BJOG 119:1455–1464

    Article  PubMed  Google Scholar 

  • Muller F, Dommergues M, Bussieres L et al (1996) Development of human renal function: reference intervals for 10 biochemical markers in fetus urine. Clin Cehm 42:1855–1860

    CAS  Google Scholar 

  • Nguyen H, Herndon C, Cooper C et al (2010) The society for fetal urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 6:212–231

    Article  PubMed  Google Scholar 

  • Nicolaides KH (2003) Screening for chromosomal defects. Ultrasound Obstet Gynecol 21:313–321

    Article  CAS  PubMed  Google Scholar 

  • Odibo AO, Marchiano D, Quinones JN, Riesch D, Egan JFX, Macones GA (2003) Mild pyelectasis: evaluating the relationship between gestational age and renal pelvic anterior-posterior diameter. Prenat Diagn 23:824–827

    Article  PubMed  Google Scholar 

  • Orzechowski KM, Berghella V (2013) Isolated fetal pyelectasis and the risk of Down syndrome: a meta-analysis. Ultrasound Obstet Gynecol 42:615–621

    Article  CAS  PubMed  Google Scholar 

  • Sairam S, Al-Habib A, Sasson S et al (2001) Natural history of fetal hydronephrosis diagnosed on mid-trimester ultrasound. Ultrasound Obstet Gynecol 17:191–196

    Article  CAS  PubMed  Google Scholar 

  • Schreuder MF, Westland R, van Wijk JA (2009) Unilateral multicystic dysplastic kidney: a meta-analysis of observational studies on the incidence, associated urinary tract malformations and the contralateral kidney. NephrolDialTransplant 6:1810–1818

    Article  Google Scholar 

  • Sebire NJ, von Kaisenberg C, Rubio C, Nicolaides KH (1996) Fetal megacystis at 10–14 weeks of gestation. Ultrasound Obstet Gynecol 8:387–390

    Article  CAS  PubMed  Google Scholar 

  • Signorelli M, Cerri V, Taddei F, Groli C, Bianchi UA (2005) Prenatal diagnosis and management of mild fetal pyelectasis: Implications for neonatal outcome and follow-up. Eur J Obstet Gynecol Reprod Biol 118:154–159

    Article  PubMed  Google Scholar 

  • Spaggiari E, Faure G, Dreux S et al (2017) Sequential fetal serum β2-microglobulin to predict postnatal renal function in bilateral or low urinary tract obstruction. Ultrasound Obstet Gynecol 49:617–622

    Article  CAS  PubMed  Google Scholar 

  • Stadié R, Strizek B, Gottschalk I et al (2016) Intrauterine vesicoamniotic shunting for fetal megacystis. Arch Gynecol Obstet 294:1175–1182

    Article  PubMed  Google Scholar 

  • Strizek B, Gottschalk I, Recker F et al (2020) Vesicoamniotic shunting for fetal megacystis in the first trimester with a Somatex ® intrauterine shunt. Arch Gynecol Obstet 302:133–140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Winyard P, Chitty LS (2008) Dysplastic kidneys. Sem Fet Neo Med 13:142–151

    Article  Google Scholar 

  • Woodward M, Frank D (2002) Postnatal management of antenatal hydronephrosis. BJU Int 89:149–156

    Article  CAS  PubMed  Google Scholar 

  • Zamprakou A, Gembruch U (2017) Fetale Therapie obstruktiver Uropathien. In: Berg C (Hrsg) Fetale Therapie. De Gruyter, Berlin, Boston, S 239–262

    Chapter  Google Scholar 

  • Zeres K, Mucher G, Becker J et al (1998) Prenatal diagnosis of autosomal recessive polycystic kidney disease (ARPKD): molecular genetics, clinical experience, and fetal morphology. Am J Med Genet 76:137–144

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Bürgerhospital Frankfurt, Frankfurt, Deutschland

    Prof. Dr. med. Franz Bahlmann

  2. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Uniklinik Köln, Köln, Deutschland

    Prof. Dr. med. Christoph Berg

  3. Ingelheim-Heidenfahrt, Deutschland

    PD Dr. med. Rolf Beetz

Authors
  1. Prof. Dr. med. Franz Bahlmann
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  2. Prof. Dr. med. Christoph Berg
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  3. PD Dr. med. Rolf Beetz
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Corresponding author

Correspondence to Franz Bahlmann .

Editor information

Editors and Affiliations

  1. Zentrum f. Kinder- & Jugendurologie, University Medical Centre Mannheim, Mannheim, Deutschland

    Raimund Stein

  2. Klinik für Kinder- & Jugendmedizin, University Hospital Cologne, Köln, Deutschland

    Lutz T. Weber

  3. Zentrum für Kinder- und Jugendurologie, University Medical Centre Mannheim, Mannheim, Baden-Württemberg, Deutschland

    Nina Younsi

  4. Zentrum- f. Kinder- & Jugendurologie, University Medical Centre Mannheim, Mannheim, Deutschland

    Katrin Zahn

  5. Kinderurologie und Kinderchirurgie, Cnopfsche Kinderklinik Nürnberg, Nürnberg, Deutschland

    Maximilian Stehr

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© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

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Bahlmann, F., Berg, C., Beetz, R. (2023). Pränatale Diagnostik und Therapie urogenitaler Fehlbildungen. In: Stein, R., Weber, L.T., Younsi, N., Zahn, K., Stehr, M. (eds) Die Kinder- und Jugendurologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63275-8_2

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  • DOI: https://doi.org/10.1007/978-3-662-63275-8_2

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-63274-1

  • Online ISBN: 978-3-662-63275-8

  • eBook Packages: Medicine (German Language)

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