MORTALITY AFTER AN ANTENATAL DIAGNOSIS OF FETAL UROPATHY

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.