Prenatal ultrasonographic evaluation and management of renal and urogenital anomalies: A comprehensive review based on experience in a tertiary care center and literature analysis.

Abstract

Introduction: Congenital renal and urogenital anomalies represent a major part of all congenital anomalies. These range from mild, transient conditions to severe forms leading to irreversible organ damage or perinatal mortality. Timely prenatal identification is crucial for expecting parents and their healthcare providers to decide about the continuation of a pregnancy or for careful planning of perinatal and postnatal care.

Objective: To describe the most common indications for referral of fetal renal and urogenital malformations, the process of narrowing the differential diagnosis based on prenatal ultrasonography and the coordination between prenatal and postnatal care in a tertiary care center in the Netherlands.

Results: The most common indications for referral of fetal renal and urogenital malformations are (1) Abnormal Renal Parenchyma, (2) Urinary Tract Dilatation, (3) Abnormal Bladder Appearance, and (4) Atypical Genitalia. In the differential diagnosis, ultrasonographic evaluation is crucial to determine the specific region of the urogenital system affected, its onset during pregnancy, and its progression throughout gestation. Integrated prenatal and postnatal care for these types of malformations relies on a multidisciplinary approach to guide parental decision-making in continuation of the pregnancy and optimize outcomes. Some cases only require routine perinatal care in secondary care centers, while complex malformations benefit from specialized planning at tertiary centers to improve outcomes.

Conclusion: Dedicated ultrasonographic evaluation of fetal renal and urogenital anomalies in a tertiary care center enables accurate diagnosis and individualized care planning, particularly in complex cases. This approach provides parents with timely information, supports decision-making, and guides individualized perinatal care.