Moderate and severe fetal pyelectasis: Correlation between prenatal aspects and postnatal outcome

Autor:	F Odicino, C Loardi, U Omodei, F Torri, C Mario Zambelloni, D Marella, M. Gregorini, M. Signorelli
Rok vydání:	2020
Předmět:	Male Pyelectasis medicine.medical_specialty Remission Spontaneous Urology Renal function Prenatal diagnosis Hydronephrosis Conservative Treatment Severity of Illness Index Ultrasonography Prenatal Group B Solitary Kidney 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pregnancy 030225 pediatrics Humans Medicine Kidney Pelvis Renal Insufficiency Radionuclide Imaging Retrospective Studies Urethral Stricture Vesico-Ureteral Reflux Fetus Creatinine 030219 obstetrics & reproductive medicine business.industry Ultrasound Infant Newborn medicine.disease chemistry Urogenital Abnormalities Pediatrics Perinatology and Child Health Urologic Surgical Procedures Female Ureter business Ureteral Obstruction
Zdroj:	Journal of Neonatal-Perinatal Medicine. 13:91-96
ISSN:	1878-4429 1934-5798
Popis:	Background Renal pelvic dilatation (RPD) is a frequent finding in fetal ultrasound. The aim of the study is to correlate the prenatally detected moderate and severe pyelectasis with the postnatal outcome. Methods A retrospective analysis involving 90 cases of prenatally detected moderate and severe RPD referred to our prenatal diagnosis centre with 18 months of urological follow-up. Prenatal ultrasound was correlated with postnatal renal function, assessed by plasmatic creatinine and/or renal scintigraphy performed before surgery. Results Cases were divided between two groups according to postnatal management: group A including 35 newborns (38.9%) that needed surgical treatment and group B with 55 patients (61.1%) who were managed conservatively. The group A presented higher median RPD (18 mm, IQR 12-25 mm) compared to the group B (11 mm, IQR 10-14 mm). The most common anomaly detected within group A was pelvi-ureteric junction (PUI) obstruction (43%). Within group B 32 cases (58%) showed spontaneous resolution of hydronephrosis during postnatal follow up. In case of moderate pyelectasis the risk of postnatal surgery was 25% and raised to 60% for severe RPD. In our study, 29 newborns showed pathologic scintigraphies: 25 required surgery while 4 did not find indication for surgery due to ipsilateral renal function irreversible damage. 6 patients had high creatinine level (>0.6 mg/dl). 35 cases out of 90 (39%) developed monolateral irreversible renal function impairment. Conclusion Moderate and severe RPD are often correlated with postnatal renal damage, therefore a close multidisciplinary follow-up is required. Prenatal scanning is highly predictive of postnatal outcome and can address properly the prenatal counseling.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4164af192ee7eb27528baf830c0f6b9e https://doi.org/10.3233/npm-180071 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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