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Master Thesis

Mégavessies fœtales, étiologies et pronostic selon l’âge gestationnel au diagnostic : à propos d’une série de 108 cas

Abstract : OBJECTIVE: To assess etiologies, prognostic factors and outcome of fetal megacystis according to the trimester. METHOD: A 10-year retrospective multicentric study was carried out from 2005 to 2015, including all cases of megacystis referred to our prenatal fetal medicine unit. The following data were collected: ultrasonographic characteristics, karyotype, fetal survival, fetopathology in cases of termination of pregnancy or fetal death, final diagnosis at birth, renal function and micturition. RESULTS: During the study period, 108 fetuses were diagnosed with megacystis, among which 49 during the first trimester, and 59 during the second or the third. Increased gestational age at diagnosis was correlated with an increased rate of live born children. During the first trimester, bladder sagittal diameter > 15 mm on ultrasound or abnormalities on karyotype, were associated with an unfavorable prognosis. On the contrary, renal function and micturition were normal among live born children with a normal karyotype and a bladder diameter under 15 mm on 1st trimester ultrasonography. During the second and third trimesters, the main etiologies were uropathies, consisting in vesicoureteral reflux and posterior urethral valves. Among live born children, 92% had a normal renal function and 86% had a satisfactory micturition. CONCLUSION: Etiologies and outcome of megacystis seem to be different according to the gestational age at diagnosis. However, the absence of ultrasonographic severity signs or karyotype abnormalities enables to offer, a close ultrasonographic monitoring all-the-while reassuring the parents on the outcome.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01628519
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Chloé Malassagne. Mégavessies fœtales, étiologies et pronostic selon l’âge gestationnel au diagnostic : à propos d’une série de 108 cas. Médecine humaine et pathologie. 2016. ⟨dumas-01628519⟩

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