Systematic sonographic bladder volume measurements at evaluation and directly after fetal myelomeningocele repair – is bladder function predictable?

Background Current data suggest a possible benefit in bladder function after fetal myelomeningocele (fMMC) repair compared to the postnatal intervention. However, it is not known which children actually benefit from fMMC repair regarding bladder function and whether there are predictive factors that could be seen sonographically. The aim of this study was to evaluate predictability of fetal bladder function at evaluation for and directly after fMMC repair.

Methods We retrospectively analyzed the sonographic bladder volume measurements of 28 fetuses at evaluation for and directly after fMMC repair. Statistical analysis was performed comparing two groups: group 1 (N=11) with neuropathic bladder dysfunction (NBD) and group 2 (N=17) children with normal bladder function postnatally. Data is presented as mean+/-SD. Statistical significance was indicated at p < 0.05.

Results At evaluation for fMMC repair the fetal bladder volume was significantly lower in group 1 compared to group 2: 0.5±0.5 ml vs. 1.0±0.6ml (p =0.03) with comparable fetal weights: 555±134g vs. 620±190g (p=0.34). Directly after surgery the fetal bladder volume was still smaller in group 1 compared to group 2: 2.5±1.9ml vs. 4.5±2.5ml (p=0.05) with comparable fetal weights: 681±126 vs. 709±152g (p=0.6).

Conclusion The presented data show a predictability of fetal bladder function by ultrasound at evaluation for and directly after fMMC repair bringing a tremendously important additional support for parents’ counseling. Nevertheless, this cohort is small and reproducibility has to be proven in bigger cohorts.

Publication History

Article published online:
07 October 2020