Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S19-7

(P)

ASSOCIATION OF FETAL MRI FINDINGS WITH ELECTROLYTE ABNORMALITIES

AND OUTCOMES IN SUSPECTED BLADDER OUTLET OBSTRUCTION

Vijaya VEMULAKONDA

, Kimberly DANNULL

, Nicholas BEHRENDT

and Mariana MEYERS

1) Children's Hospital Colorado, Pediatric Urology, Aurora, USA - 2) Children's Hospital Colorado, Pediatric Radiology,

Aurora, USA - 3) Colorado Institute for Maternal and Fetal Health, Maternal-Fetal Medicine, Aurora, USA

PURPOSE

The objective of this study was to examine the association of fetal magnetic resonance imaging (MRI) and ultrasound

(US) findings with electrolytes and outcomes in fetuses with suspected bladder outlet obstruction (BOO).

MATERIAL AND METHODS

We conducted a retrospective cohort study of patients with a prenatal diagnosis of BOO from 9/1/2012 to 10/1/2014.

MRI and US images were independently reviewed by two pediatric radiologists who were blinded to outcome. Imaging

findings assessed included renal cortical thickness, renal cysts, hydronephrosis, urinary ascites, and amniotic fluid level.

Electrolytes were classified as normal or abnormal based on published thresholds. Outcome was classified as no

treatment/live birth, fetal intervention (valve ablation, amnioinfusion, vesicoamniotic shunt), and fetal

demise/termination. Analyses were conducted using Fisher’s exact test.

RESULTS

26 patients meeting study criteria were identified. 65% of patients had electrolytes, of which 52.9% were abnormal.

Oligohydramnios by MRI was associated with electrolyte abnormalities (p=0.036). 34.6% of patients underwent

intervention, 30.8% were observed, and 34.6% were terminated. Fetal intervention or demise were associated with

oligohydramnios by MRI (p<0.001) and US (p=0.007) and renal cysts by MRI (p=0.009). No other US or MRI findings

were associated with abnormal electrolytes or treatment.

CONCLUSIONS

In this series, oligohydramnios by MRI or US and renal cystic changes by MRI were associated with fetal intervention or

demise. Oligohydramnios by MRI was also associated with abnormal electrolytes. These findings suggest that fetal MRI

may provide additional information as compared to US when considering the potential prognosis in fetuses with

suspected BOO and may help guide prenatal treatment decisions.