Basic principles of prenatal counseling by a pediatric urologist: challenges and opportunities

This publication is based on the results of the accumulated experience of a practicing pediatric urologist during prenatal counseling in the framework of the regional prenatal consultation and is the result of long-term research work in the field of pediatric urology, fetal urology, prenatal ultrasound diagnosis of urinary system defects. The system of prenatal diagnosis of urinary system pathology proposed in the article will significantly increase the reliability of antenatal diagnosis and prognosis, plan the timing, scope and tactics of treatment activities carried out as early as possible after birth at the stage of preclinical manifestations. To do this, it is assumed, firstly, the creation of a group of perinatal observation of patients; secondly, the use of evaluation and interpretation of ultrasound data that determine the level and nature of urodynamic lesions of the fetal urinary system, the severity of urinary tract dilatation, the preservation of renal parenchyma, which is the basis for prenatal diagnosis, evaluation of prospective kidney function. The signs of prognostically unfavorable malformations of the urinary system, in which the question of termination of pregnancy is discussed, are highlighted.