Fetal pyelectasis: Is it always 'physiologic'?
| Autor: | Maha S. Dennaoui, Andres A. Mejides, Abdallah M. Adra, Samir N. Beydoun |
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| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Voiding cystourethrogram Urinary system Urology Sensitivity and Specificity Vesicoureteral reflux Ultrasonography Prenatal Pyelectasis Predictive Value of Tests Pregnancy medicine Humans Kidney Pelvis Vesico-Ureteral Reflux Kidney medicine.diagnostic_test business.industry Infant Newborn Obstetrics and Gynecology medicine.disease Surgery Fetal Diseases medicine.anatomical_structure Renal pathology Predictive value of tests Female Kidney Diseases business Renal pelvis Dilatation Pathologic Ureteral Obstruction |
| Zdroj: | American Journal of Obstetrics and Gynecology. 173:1263-1266 |
| ISSN: | 0002-9378 |
| DOI: | 10.1016/0002-9378(95)91367-x |
| Popis: | OBJECTIVE: Our purpose was to determine the degree of fetal pyelectasis predictive of neonatal renal pathologic processes. STUDY DESIGN: Eighty-four cases of pyelectasis were identified during the study period (1989 through 1993). Fetuses with an anteroposterior diameter of the renal pelvis ≥4 mm before 33 weeks or ≥7 mm after 33 weeks without caliectasis were included. Fetuses with an anteroposterior diameter of >10 mm were excluded. Postnatal evaluation included renal sonogram, voiding cystourethrogram, and renal flow and function studies. RESULTS: Sixteen cases were excluded because of incomplete postnatal workup. Renal pathologic processes were found in 30 of 68 (44%) at birth: the most common were ureteropelvic junction obstruction (37%) and vesicoureteral reflux (33%). Only four cases required surgical intervention (13%), and the remaining 87% were managed conservatively. A normal urinary tract was found in 25% of the infants and the remaining 21 of 68 (31%) had regression of pyelectasis before birth. Fetuses with a dilated anteroposterior diameter ≥8 mm after 28 weeks' gestation were found to have renal pathologic features in two of three of the cases, with sensitivity, specificity, and positive and negative predictive values of 87%, 41%, 66.7% and 70%, respectively. CONCLUSION: Fetuses with an anteroposterior diameter of the renal pelvis ≥8 mm after 28 weeks' gestation require appropriate urologic evaluation after birth. |
| Databáze: | OpenAIRE |
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