Abstract
Objective
To examine the prenatal diagnosis rates of bladder exstrophy (BE) and Omphalocele-Exstrophy-Imperforate
anus-Spinal Defect Syndrome (OEIS) in a large cohort of patients over a 20-year period.
We hypothesized that prenatal diagnosis rates improved over time due to evolving techniques
in fetal imaging.
Methods
A multi-institutional database was queried to identify BE or OEIS patients who underwent
primary closure between 2000 and 2020. We retrospectively determined prenatal or postnatal
diagnosis. Those with unknown prenatal history were excluded. Multivariable logistic
regression was used to investigate temporal pattern in rate of prenatal diagnosis
while adjusting for sex and treating institution.
Results
Among 197 BE and 52 OEIS patients, 155 BE and 45 OEIS patients had known prenatal
history. Overall prenatal diagnosis rates of BE and OEIS were 47.1% (73/155) and 82.2%
(37/45), respectively. Prenatal diagnosis rate was significantly lower in BE compared
to OEIS (P <.0001). The prenatal diagnosis rate for BE significantly increased over time (OR
1.10; [95%CI: 1.03-1.17]; P = .003). Between 2000 and 2005, the prenatal diagnosis rate of BE was 30.3% (10/33).
Between 2015 and 2020, prenatal diagnosis rate of BE was 61.1% (33/54). Prenatal diagnosis
rate for OEIS did not change over time. Rates of prenatal diagnosis did not differ
by sex or treating institution.
Conclusion
Rates of prenatal diagnosis of BE and OEIS are higher than previously reported. Prenatal
diagnosis rate of BE doubled in the last 5 years compared to the first 5 years of
the study period. Nonetheless, a significant proportion of both BE and OEIS patients
remain undiagnosed prior to delivery.
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Article info
Publication history
Published online: November 29, 2022
Accepted:
November 17,
2022
Received:
October 28,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Financial Disclosure: I certify that all authors have no relevant financial relationship associated with this study or any commercial products or provider of commercial services that may be relevant to this study.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
