Prognostic value of fetal urine beta- 2 microglobuline in vesicoamniotic shunting therapy for fetal obstructive uropathy

Abstract

Introduction. Fetal obstructive uropathy can be treated early in pregnancy by intrauterine vesicoamniotic shunting, immediately after diagnosis by ultrasound, in specific cases with a favorable prognosis in renal function using fetal urine beta-2 microglobulin. Objective: To determine the changes of beta-2 microglobulin in consecutive samples of fetal urine in 48 – 72 hour-intervals in fetuses with obstructive uropathy at 16 weeks of gestation. Methods: We designed a descriptive and longitudinal study, including 15 pregnant women whose fetuses were diagnosed with obstructive uropathy without chromosomal abnormalities, performing vesicocentesis for urinary biometry. Results: Beta-2 microglobulin values were higher than 4 mg/dL in the first vesicocentesis of all 15 cases and decreased to less than 4 mg/dL in 7 cases (46.6%) after the second vesicocentesis. In all cases when beta-2 microglobulin was less than 8 mg/dL in the first vesicocentesis, there was a decrease to nearly 4 mg/dL (maximum 4.3 mg/dL) in the second vesicocentesis. Conclusions: Vesicoamniotic shunting should be performed in all cases of fetal obstructive uropathy when the values of beta-2 microglobulin are less than 8 mg/dL in the first vesicocentesis.