A multidisciplinary clinic was formed for Southern Alberta to assess high risk pregnancies with or without congenital abnormalities in Oct '93. From Oct'93 to Nov '95, 32 pregnant mothers with definite or possible fetal RTA were reviewed. This retrospective study was done to evaluate the outcome of these pregnancies. The mothers and babies charts were reviewed, the results of pre and post natal investigations were compared and operative events recorded.

RESULTS: Table One foetus was noted to have no RTA on a subsequent antenatal ultrasound scan. Outcome information was available for 28/31 [90%] pregnancies. Antenatal diagnoses were accurate in 75% of cases although multiple/chromosomal abnormalities [chrom abn], posterior urethral valves [PUV] and vesico-ureteric reflux [VUR] were not reliably diagnosed. Some abnormalities were not confirmed postnatally although not every newborn was fully investigated. Eleven [34%] resulted in non-survivors. Seven died antenatally and 4 in the neonatal period. Seven[22%] babies had surgery in the 1st year of life for PUV resection-1, pyeloplasty-1, ureterocoele resection-1, nephrostomy-3 and nephrectomy-1. Two infants have chronic renal failure at follow up.

Table 1
Full size table

CONCLUSION: In this review 34% of the foetuses diagnosed to have RTA did not survive. Foetal RTA were not always confirmed postnatally. This suggests that foetal RTA should be followed closely antenatally and postnatally. RTA may be associated with other anomalies, and their short and long term prognosis depends on the early recognition of these associated anomalies.