Aims and objectives
Kidney and urinary tract anomalies are among the most frequently identified congenital malformations accounting for 20–30% of all ultrasound-detected anomalies1.
Antenatal US is an excellent technique for their detection,
with an overall sensitivity of approximately 90%1,2.
Antenatal hydronephrosis (ANH) is the dilation of the fetal renal collecting system and corresponds to the most common urinary tract anomaly detected on prenatal ultrasonography (US),
being reported in approximately 1-5% of all pregnancies3.
Usually ANH is physiologic or transient,
having no pathological meaning4.
However it can represent important...
Methods and materials
A retrospective analysis of our institution’s database for fetal urinary tract anomalies was made.
Ultrasound database of the Obstetrics and Radiology departments were reviewed and all prenatal diagnosis of urinary tract anomalies between January 2012 and July 2017 were included.
Follow-up data was obtained from the clinical records of Pediatrics and Pediatric Surgery departments.
Newborns with either prenatal or postnatal ultrasound performed at other institution and patients without proper follow-up data were excluded.
The diagnosis of ANH was based on the measurement of the anterior-posterior...
Results
A total of 54 urinary tract anomalies were reviewed.
The mean maternal age at prenatal diagnosis was 31 years old and the median gestational age was 27 weeks.
More than two thirds of the fetus were male (68.5%).
Urinary tract dilatation was the most frequent diagnosis present in 51 patients (94.4%).
Severe hydronephrosis,
with anterior-posterior renal pelvis diameter above 10 mm,
was diagnosed in 35.3% of the cases.
Multicystic dysplastic kidney was the most frequent detected structural malformation of the urinary tract,
present in 5...
Conclusion
ANH was the most frequent urinary tract malformation (94.4%) and multicystic dysplastic kidney was the most diagnosed structural malformation (9.2%).
The presence of a severe ANH,
with an APPD superior to 10 mm can help to predict postnatal outcomes and the need for surgery.
There was a high level of correspondence between prenatal and postnatal diagnosis,
demonstrating that prenatal US is a reliable method to establish the diagnosis of urinary tract malformations.
References
1. Queiber-Luft A SG,
Wiesel A,
et al.
Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990–1998).
Arch Gynecol Obstet. 2002;266:163–7.
2. Clayton DB BJ.
Prenatal ultrasound and urological anomalies.
Pediatr Clin North Am. 2012;59:739–56.
3. Hiep Nguyen AH,
Christopher Cooper,
John Gatti,
Andrew Kirsch.
The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis.
Journal of Pediatric Urology Company.
Elsevier 2010;1477-5131.
4. Hiep Nguyen CB,
Bryann Bromley,
Jeffrey Campbell,...