A 5‐year audit of 778 neonatal renal scans (Part 2). Miscellaneous anomalies in 59 infants: A pictorial presentation

Abstract

In this 5-year review of 778 neonatal renal scans seen in an obstetric hospital, Mercy Hospital for Women, Melbourne, most infants were referred because of antenatal ultrasound findings. Ninety-two percent of these had fetal pyelectasis. The results were classified on the ultrasound findings. The majority of neonates (76%) had a normal postnatal scan. A number had vesicoureteric reflux found on micturating cystourethrogram. Persisting mild/moderate pyelectasis or hydronephrosis (15%) proved to be a normal variant in many infants, but had a similar appearance to those with an early obstructive cause (1%). There were 59 infants (8%) with a miscellaneous group of renal anomalies, many with a characteristic antenatal ultrasound appearance suggesting the diagnosis. Review of these 59 infants illustrates the anomalies seen and reports the associated investigations and subsequent outcome in most cases.

A 5‐year audit of 778 neonatal renal scans (Part 1): Perplexing pyelectasis and suggested protocol for investigation

“…A miscellaneous group of anomalies seen in 59 (8%) of neonates were classified according to the final diagnosis. This group of infants has been separately reported in Part 2 2 .…”

“…Some structural renal anomalies have a characteristic appearance suggesting the diagnosis. This group of infants with structural abnormalities had been separately reported and illustrated (Part 2) 2 . In this 5‐year consecutive series of neonatal scans, the results have been classified according to postnatal diagnosis.…”

Flere påviste misdannelser i nyrer og urinveier

“…De aller fleste av disse var hydronefroser som ikke trengte kirurgisk behandling (fig 2). Det har over tid både i Norge og andre land vaert varierende og til dels uklare kriterier for diagnosen føtal hydronefrose (7)(8)(9). Studier angir at 47-63 % av prenatalt påviste hydronefroser er forbigående eller fysiologiske (10, 11).…”

“…Det var naer dobbelt så mange gutter som piker i materialet, noe som går igjen i andre studier (6,8,11,14,15). Urinveiene hos gutter er embryologisk mer komplekse enn hos piker, med større risiko for feilutvikling.…”

“…obstruksjon med dilatasjon av urinveiene proksimalt for obstruksjonen). Fordelingen av diagnoser i vårt materiale er likevel mye lik den i andre studier (4,8,10,11,14,15). Dominansen av venstresidige anomalier, når disse forekom ensidig, er også funnet av andre, uten at man kjenner noen sikker årsak (10).…”