Evaluation of Postnatal Renal Function in Fetuses With Bilateral Obstructive Uropathies by Proton Nuclear Magnetic Resonance Spectroscopy

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Abstract

OBJECTIVES

To precisely evaluate fetal renal function in cases of bilateral fetal urinary tract obstruction, we analyzed fetal urine metabolites by nuclear magnetic resonance spectroscopy.

STUDY DESIGN

Fifty-six specimens of fetal urine samples in utero were retrospectively analyzed by proton nuclear magnetic resonance. Group 1 (n = 21) consisted of survivors for >=1 year with normal serum creatinine (<50 micromole/L), for group 2 (n = 17) of survivors with abnormal serum creatinine (>50 micromole/L), and group 3 (n = 18) of those with bilateral histologic dysplasia associated with fetal (termination of pregnancy) or neonatal death.

RESULTS

A specific nuclear magnetic resonance profile was obtained for each of the three groups of renal function. A two-dimensional representation of alanine-valine and valine-threonine concentrations allows clear differentiation between the three degrees of renal function, with a sensitivity and specificity of 88% and 86%, respectively.

CONCLUSIONS

In fetal bilateral urinary tract obstruction a fetal urine nuclear magnetic resonance profile allows an accurate identification of renal function at birth. (AM J OBSTET GYNECOL 1994;170:595-602.)

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