Resultado perinatal de fetos com malformações do trato urinário

Abstract

IntroduçãoAs anomalias congênitas do trato urinário são responsáveis por grande parte das alterações que levam à insuficiência crônica e falência renais na infância [1][2][3] . Nas últimas duas décadas, com o desenvolvimento da ultra-sonografia obstétrica e de estudos experimentais que elucidaram os achados ultra-sonográficos, não só o momento do diagnóstico foi antecipado, como também a histó-ria natural destas condições pôde ser melhor compreendida 4 . A avaliação prospectiva de fetos com malformações do trato urinário demonstrou que os principais fatores relacionados ao prognóstico foram: a lateralidade do acometimento (uni ou bilateral), a ocorrência de oligoâmnio, sendo que a condição precipitante do óbito neonatal foi a hipoplasia pulmonar 2,5,6 . Além do acometimento bilateral e do oligoâmnio, a presença de displasia ou agenesia renal, assim como a presença de malformações extra-renais, são sinalizadores de pior prognósti-co 7 . Malformações de outros órgãos ou sistemas

Pregnant women infected by the Zika virus: Ultrasound findings and growth patterns of fetuses with and without microcephaly

“…10 However, the fact that tests were not performed does not affect the results, as there is little doubt that the cause of the abnormalities in the microcephaly group was ZIKV, and this association has indeed been confirmed. 22 Furthermore, the study was conducted during an epidemic of the virus in the Brazilian state of Pernambuco, which solidifies the causal association between microcephaly and ZIKV infection in our study. 10 In the group without microcephaly, in which diagnosis was based on reported symptoms, these may not have been cases of ZIKV infection.…”

“…As these were the first cases of pregnant women with fetal abnormalities and an infection suggestive of ZIKV, no protocol of tests had yet been established 10 . However, the fact that tests were not performed does not affect the results, as there is little doubt that the cause of the abnormalities in the microcephaly group was ZIKV, and this association has indeed been confirmed 22 . Furthermore, the study was conducted during an epidemic of the virus in the Brazilian state of Pernambuco, which solidifies the causal association between microcephaly and ZIKV infection in our study 10 .…”

“…20 Mean AFI was lower in the microcephaly group from the 30th week onwards compared with the group without microcephaly; however, values were within normal limits. 21 Lower AFI values are common in maternal infections such as urinary tract infections 22 and congenital infections such as cytomegalovirus. 23 The fact that diagnostic laboratory tests were not performed is a limitation of the present study.…”

Agenesia renal: uma malformação congênita detectável na gestação

“…Apesar dos portadores de agenesia renal apresentarem aparentemente uma qualidade de vida igual à população em geral, existem estudos que afirmam haver piora da função renal a longo prazo (SABOIA et al, 2017). As anomalias congênitas do trato urinário são responsáveis por grande parte das alterações que levam a insuficiência crônica e falência renais na infância (MACEDO et al, 2003).…”