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Objective: The objective of the study was to evaluate prenatal sonographic signs that distinguish male fetuses with posterior urethral valves (PUV) from those with vesicoureteral reflux (VUR)., Methods: Prenatal data were retrospectively retrieved from all consecutive women delivering between 2003 and 2012 of a male newborn with a postnatal diagnosis of PUV or VUR. Prenatal parameters included fetal bladder characteristics, identification of a dilated posterior urethra, and change in shape and size in the fetal renal pelvis or ureter., Results: One hundred thirty-six women gave birth to a male newborn with a postnatal diagnosis of PUV (n = 49) or VUR (n = 87). The presence of posterior urethral dilatation [21 (42.9%) fetuses versus 0 (0%), p = 0.000], a thickened fetal bladder wall [37 (75.5%) vs 4 (4.6%), p = 0.000], and anhydramnios [14 (28.6%) vs 0, p = 0.000] were strongly associated with the postnatal diagnosis of PUV. Change in shape and size in the fetal renal pelvis or ureter was observed in 15 (17.2%) of 87 children with VUR versus 1 (2.0%) out of 49 with PUV (p = 0.010)., Conclusions: Prenatal ultrasound may differentiate with reasonable accuracy male fetuses with a postnatal diagnosis of PUV from those with VUR. © 2016 John Wiley & Sons, Ltd., (© 2016 John Wiley & Sons, Ltd.)

Objectives: To evaluate prenatal sonographic signs that distinguish male children born alive with posterior urethral valves (PUV) from those with vesicoureteral reflux (VUR). Methods: Antenatal data were retrospectively retrieved for all pregnant women who delivered consecutively between 2003 and 2012 a boy born alive with a postnatal diagnosis of PUV or VUR. Prenatal parameters included fetal bladder characteristics, identification of a dilated posterior urethra, fluctuating activity in the fetal renal pelvis or ureter and amniotic fluid volume. Results: 123 women gave birth to male infants born alive for whom there was a postnatal diagnosis of PUV in 36 cases and VUR in 87. A thickened bladder wall was highly associated with the diagnosis of PUV (30 fetuses [83.3%] versus 4 fetuses [4.6%] with VUR, p<0.000, OR 100 [95% CI 27.0-333]). An enlarged bladder was observed in 20 fetuses (55.6%) with a postnatal diagnosis of PUV and in 29 fetuses (33.3%) with VUR (p=0.027, OR 2.50 [95% CI 1.13-5.53]). A posterior urethral dilatation was visualized in 18 fetuses (50.0%) with PUV and was not present in any cases of fetuses with VUR (p<0.000, OR 173 [95% CI 9.97-3001]). In addition, oligoanhydramnios appeared to be strongly associated with the postnatal diagnosis of PUV compared with that of VUR (13 [36.1%] versus 7 [8.05%], p=0.000). Fluctuating activity in the fetal renal pelvis or ureter was observed in15 (17.2%) of 87 children with reflux, versus 1 (2.78%) of 36 newborns with valves (p=0.037). Conclusions: This study demonstrates that prenatal ultrasound can differentiate with reasonable accuracy male neonates born alive with a postnatal diagnosis of PUV from those with VUR. Dilated posterior urethra, thickened bladder wall and oligoanhydramnios were significantly associated with PUV. The best indicator of VUR was a fluctuating activity in ureters. These results may help in perinatal management and prenatal counselling. [ABSTRACT FROM AUTHOR]