{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T20:05:24Z","timestamp":1773259524701,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To construct reference values for fetal urinary bladder distension in pregnancy and use <jats:italic>Z<\/jats:italic>\u2010scores as a diagnostic tool to differentiate posterior urethral valves (PUV) from urethral atresia (UA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cross\u2010sectional study in healthy singleton pregnancies aimed at constructing nomograms of fetal urinary bladder diameter and volume between 15 and 35\u2009weeks' gestation. <jats:italic>Z<\/jats:italic>\u2010scores of longitudinal bladder diameter (LBD) were calculated and validated in a cohort of fetuses with megacystis with ascertained postnatal or postmortem diagnosis, collected from a retrospective, multicenter study. Correlations between anatomopathological findings, based on medical examination of the infant or postmortem examination, and fetal megacystis were established. The accuracy of the <jats:italic>Z<\/jats:italic>\u2010scores was evaluated by receiver\u2010operating\u2010characteristics (ROC)\u2010curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nomograms of fetal urinary bladder diameter and volume were produced from three\u2010dimensional ultrasound volumes in 225 pregnant women between 15 and 35\u2009weeks of gestation. A total of 1238 urinary bladder measurements were obtained. <jats:italic>Z<\/jats:italic>\u2010scores, derived from the fetal nomograms, were calculated in 106 cases with suspected lower urinary tract obstruction (LUTO), including 76 (72%) cases with PUV, 22 (21%) cases with UA, four (4%) cases with urethral stenosis and four (4%) cases with megacystis\u2010microcolon\u2010intestinal hypoperistalsis syndrome. Fetuses with PUV showed a significantly lower LBD <jats:italic>Z<\/jats:italic>\u2010score compared to those with UA (3.95 <jats:italic>vs<\/jats:italic> 8.83, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). On ROC\u2010curve analysis, we identified 5.2 as the optimal <jats:italic>Z<\/jats:italic>\u2010score cut\u2010off to differentiate fetuses with PUV from the rest of the study population (area under the curve, 0.84 (95%\u2009CI, 0.748\u20130.936); <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; sensitivity, 74%; specificity, 86%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Z<\/jats:italic>\u2010scores of LBD can distinguish reliably fetuses with LUTO caused by PUV from those with other subtypes of LUTO, with an optimal cut\u2010off of 5.2. This information should be useful for prenatal counseling and management of LUTO. \u00a9 2021 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23647","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T05:07:01Z","timestamp":1618636021000},"page":"875-881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["<i>Z<\/i>\u2010scores of fetal bladder size for antenatal differential diagnosis between posterior urethral valves and urethral atresia"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7003-4984","authenticated-orcid":false,"given":"F.","family":"Fontanella","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Isala Hospital  Zwolle The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Groen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology\u2010HPC FA40, University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4089-9973","authenticated-orcid":false,"given":"L. K.","family":"Duin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Isala Hospital  Zwolle The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Suresh","sequence":"additional","affiliation":[{"name":"Mediscan Ultrasound Center  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-0626","authenticated-orcid":false,"given":"C. M.","family":"Bilardo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Diagnosis University Medical Center Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Amsterdam UMC, Location VU  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2008.00940.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1074"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03476.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2007.08.007"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40748-015-0026-1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)66174-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1878"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17422"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18990"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19172"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03451.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1993.03060378.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1973.tb16049.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19182"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000488282"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2736"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13293"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14652"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8981"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4771"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8981"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2014.132"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14808"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1878"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.08060387.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.81"},{"key":"e_1_2_7_28_1","volume-title":"Antenatal diagnosis and management of fetal megacystis and lower urinary tract obstruction. PhD thesis","author":"Fontanella F.","year":"2019"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5573"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000142136.17222.07"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-007-0360-2"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90020-5"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23647","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.23647","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T08:48:03Z","timestamp":1692866883000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.23647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/uog.23647"],"URL":"https:\/\/doi.org\/10.1002\/uog.23647","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"2020-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}