EARLY URETHRAL OBSTRUCTION SEQUENCE - A LETHAL ENTITY

Early urethral obstruction sequence (EUOS) is characterized by severe bladder distension by the end of the first trimester of pregnancy, res ulting in renal dysplasia or hydronephrosis, oligohydramnios and subse quent lung hypoplasia. We reviewed the outcome of 18 fetuses with susp ected EUOS. The mean gestational age at the time of diagnosis was 15 w eeks. In 1 fetus, a vesicoamniotic shunt was placed unsuccessfully. Pr egnancy was terminated in 11 fetuses and 9 showed signs of pulmonary h ypoplasia and severe renal disease on autopsy. In 3 cases, the autopsy material could be evaluated. Premature delivery occurred in 2 patient s, and 5 chose to deliver at term. All 7 fetuses died soon after birth because of respiratory failure and lung hypoplasia; renal abnormaliti es were also found on autopsy. Since it is currently not clear whether prenatal intervention will prevent renal dysplasia and it is not know n how early it should be done to prevent pulmonary hypoplasia, we beli eve that termination of pregnancy should be discussed when EUOS is sus pected.