Moderate and severe fetal pyelectasis: Correlation between prenatal aspects and postnatal outcome.
J Neonatal Perinatal Med
; 13(1): 91-96, 2020.
Article
em En
| MEDLINE
| ID: mdl-31609706
ABSTRACT
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 (18âmm, IQR 12-25âmm) compared to the group B (11âmm, IQR 10-14âmm). 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 (>0.6âmg/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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Urológicos
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Obstrução Ureteral
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Refluxo Vesicoureteral
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Pielectasia
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Tratamento Conservador
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Hidronefrose
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
J Neonatal Perinatal Med
Ano de publicação:
2020
Tipo de documento:
Article