A longitudinal study identified 987 foetal uropathies over a 13-year p
eriod. There were 147 deaths. Forty infants died as a result of a leth
al uropathy in the presence of associated congenital anomalies. Sixty
six infants with an isolated uropathy died. There were 4 cot deaths, 2
obstetric related deaths, acid 34 deaths caused by associated congeni
tal anomalies. There was 1 termination of pregnancy following a false-
positive diagnosis of uropathy. Of the 147 deaths, 34 occurred postnat
ally, 20 within 24 hours. Twenty-nine infants were spontaneously abort
ed. There were 78 terminations of pregnancy, 43% occurring after 24 we
eks of gestation. There was complete concordance in antenatal and post
natal diagnoses in 113 (77%) cases and incomplete concordance in 19 (1
3%) cases. There were 14 false negative diagnoses (9.5%). The relative
frequency of different lethal congenital uropathies is detailed. Accu
rate in utero diagnosis of foetal uropathy and hence prediction of out
come is possible. The relatively late gestational age at time of diagn
osis remains a constraint when fatal malformations would otherwise pro
mpt termination of pregnancy.