PRENATALLY DETECTED POSTERIOR URETHRAL VALVES - IS GESTATIONAL-AGE ATDETECTION A PREDICTOR OF OUTCOME

Between 1982 and 1992, 67 boys with posterior urethral valves were man aged at our hospital, including 32 (48%) in whom the condition was det ected prenatally. We examined the relationship between gestational age at detection and outcome at a median followup of 3.9 years (range 4 m onths to 10 years). Detection at or before 24 weeks of gestation predi cted a poor outcome with 9 of 17 patients (53%) dead or in chronic ren al failure at followup. Of the cases detected later in pregnancy only 1 had a poor outcome (p = 0.01). All of the cases detected after 24 we eks of gestation had had normal second trimester scans. Growth paramet ers for boys in the early and late detection groups were not statistic ally different. However, there was a significant association between r enal failure and growth with 67% versus 14% having heights less than t he 3rd percentile (p = 0.05). Respiratory distress at birth predicted a poor outcome, while the presence of palpable abdominal abnormalities or vesicoureteral reflux failed to predict outcome.