[Fetal uropathies and pulmonary hypoplasia].
The author discusses the role of fetal uropathies in the development of pulmonary hypoplasia. The predisposing abnormalities may occur at various locations, including the kidneys and the efferent urinary ducts (ureters, urocyst, urethra). Following a brief general overview of the normal development of the urinary system, the developmental abnormalities are discussed. These anomalies interfere with the secretion of urine or, alternatively, may hinder or obstruct its elimination through the urinary ducts, thus leading to oligohydramnios. Inadequate production of amniotic fluid hinders the respiratory movements and unfavourable affects or even arrests pulmonary development. The stage of lung maturity at the time of birth offers a key to the determination of the time of initial occurrence of pulmonary hypoplasia. Regretfully, the therapeutic options are rather limited, due to the substantial maternal and fetal risks of in utero fetal surgery. In case of valvula urethrae posterior, a vesico-amniotic shunt offers a realistic chance for success.