{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:49:04Z","timestamp":1788306544127,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To present a single center experience of a standardized prenatal multidisciplinary management protocol for fetal lower urinary tract obstruction (<jats:styled-content style=\"fixed-case\">LUTO<\/jats:styled-content>) and to propose a classification of fetal <jats:styled-content style=\"fixed-case\">LUTO<\/jats:styled-content> based on disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of 25 consecutive fetal patients with prenatal diagnosis of primary <jats:styled-content style=\"fixed-case\">LUTO<\/jats:styled-content>. Fetal intervention was offered after evaluation by a multidisciplinary team. Analyses were conducted using Bayesian methodology to determine predictors of survival at 6\u2009months postpartum. Odds ratios (<jats:styled-content style=\"fixed-case\">ORs<\/jats:styled-content>) with 95% credibility intervals are reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen  (60.0%) of the 25 patients referred for assessment survived to postnatal evaluation. Fetal vesicoamniotic shunt was placed in 14 (56.0%) patients with 12 survivors. Multivariable analysis suggested that fetal intervention (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 6.97 (0.88\u201370.16), Pr(<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> &gt;\u20091)\u2009=\u200996.7%), anhydramnios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.12 (0.04\u20130.35), Pr(<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2009&lt;\u20091)\u2009=\u200999.9%), favorable fetal urine analysis (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 3.98 (0.63\u201325.15), Pr(<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> &gt;\u20091)\u2009=\u200992.7%) and absence of renal cortical cysts (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 3.9 (0.66\u201324.2), Pr(<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> &gt;\u20091)\u2009=\u200993.3%) were predictors of survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fetal intervention and fetal renal function were independently associated with postnatal survival of fetuses with <jats:styled-content style=\"fixed-case\">LUTO<\/jats:styled-content>. A classification based on the severity of disease is proposed. Copyright \u00a9 2015 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15844","type":"journal-article","created":{"date-parts":[[2015,12,22]],"date-time":"2015-12-22T07:58:49Z","timestamp":1450771129000},"page":"476-482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Fetal lower urinary tract obstruction: proposal for standardized multidisciplinary prenatal management based on disease severity"],"prefix":"10.1002","volume":"48","author":[{"given":"R.","family":"Ruano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Sananes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Urology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Au","sequence":"additional","affiliation":[{"name":"Division of Pediatric Urology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Koh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Urology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Gargollo","sequence":"additional","affiliation":[{"name":"Division of Pediatric Urology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Shamshirsaz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Safdar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Moaddab","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Fetal Center\u00a0\u2013\u00a0Texas Children's Hospital Pavilion for Women  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Public Health Strasbourg University Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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