Pregnancy after lower urinary tract reconstruction for congenital abnormalities

Authors from London evaluated 20 women with treated and reconstructed congenital urinary tract abnormalities, and assessed the effect this might have on renal function, pregnancy and delivery. They found that pregnancy had no long‐term effect on renal function and did not compromise reconstruction. However, there was a substantial complication rate and an increased need for Caesarean section. Nevertheless they felt pregnancy in women such as these is safe for mothers and baby. OBJECTIVE To evaluate the effect of pregnancy on renal function, and the effect of congenital urinary tract abnormality and reconstruction on pregnancy and delivery. PATIENTS AND METHODS The case notes were reviewed of 20 women (median age 32.5 years) who had had 29 live babies. Data collected included patient demographics, congenital urological abnormality, urological reconstructive procedure(s) and any subsequent urological complications. Pregnancy details, including urological and obstetric complications, presentation and mode of delivery, were obtained via a postal questionnaire from the relevant obstetrician. RESULTS Seven patients had exstrophy‐epispadias, seven spinal dysraphism, two sacral agenesis, and one each cerebral palsy, epispadias, imperforate anus and small bladder with vesico‐ureteric reflux and congenital incontinence. They had had a mean (range) of 5.7 (1–12) urological reconstructive procedures each. Patients with exstrophy‐epispadias had significantly more operations (mean 7.8) than those with spinal dysraphism (mean 4.14) or other diagnoses (mean 2.6) (P