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Case ReportOpen Access
Prenatal Diagnosis of Fetal Bladder Outlet Obstruction at Songklanagarind Hospital: Report of 5 Cases
Suwanrath C 
,
Suntharasaj T ,
Leetanapom R ,
Mitamun W
,
Suntharasaj T ,
Leetanapom R ,
Mitamun W THITIMA SUNTHARASAJ, M.D.*,
WINYOU MITARNUN, M.D.**
Five cases of fetal bladder outlet obstruction prenatally diagnosed in the Perinatology
Unit, Department of Obstetrics and Gynaecology, Songklanagarind Hospital, Songkhla, from January
1990 to September 1999 were reported. Ultrasound findings demonstrated megacystis, various
degrees of hydroureter and hydronephrosis and oligohydramnios. Sex could be determined in only
four cases and all were male. Chromosome abnormality (trisomy 18) was documented in one
case. Postmortem results in three cases established that posterior urethral valves were the cause
of obstruction. All cases in our series had poor outcome based on gestational age at first diag-
nosis, sonographic findings, fetal urinalysis, and chromosome abnormality. Four cases underwent
termination of pregnancy and the other resulted in a dead fetus
in utero.
The outcome of some
cases may be improved by using the vesicoarnniotic shunt placement procedure that increases the
likelihood of fetal survival. Therefore, the recommendation is to establish this procedure at Songkla-
nagarind Hospital in the future.
Key word : Bladder Outlet Obstruction, Lower Obstructive Uropathy, Prenatal Diagnosis, Ultra-
sound
SUWANRATH C, SUNTHARASAJ T,
LEETANAPORN
WINYOU MITARNUN, M.D.**
Five cases of fetal bladder outlet obstruction prenatally diagnosed in the Perinatology
Unit, Department of Obstetrics and Gynaecology, Songklanagarind Hospital, Songkhla, from January
1990 to September 1999 were reported. Ultrasound findings demonstrated megacystis, various
degrees of hydroureter and hydronephrosis and oligohydramnios. Sex could be determined in only
four cases and all were male. Chromosome abnormality (trisomy 18) was documented in one
case. Postmortem results in three cases established that posterior urethral valves were the cause
of obstruction. All cases in our series had poor outcome based on gestational age at first diag-
nosis, sonographic findings, fetal urinalysis, and chromosome abnormality. Four cases underwent
termination of pregnancy and the other resulted in a dead fetus
in utero.
The outcome of some
cases may be improved by using the vesicoarnniotic shunt placement procedure that increases the
likelihood of fetal survival. Therefore, the recommendation is to establish this procedure at Songkla-
nagarind Hospital in the future.
Key word : Bladder Outlet Obstruction, Lower Obstructive Uropathy, Prenatal Diagnosis, Ultra-
sound
SUWANRATH C, SUNTHARASAJ T,
LEETANAPORN
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