Frequency and prediction of persistent urinary tract dilation in third trimester and postnatal urinary tract dilation in infants following diagnosis in second trimester

Green, C. A.; Adams, Jenna C; Goodnight, William; Odibo, Anthony O.; Bromley, Bryann; Jelovsek, J. Eric; Stamilio, David M.; Venkatesh, Kartik K.

doi:10.1002/uog.23758

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…The persistence rate was signi cantly higher in UTD-A2-3 than in UTD-A1. (13) In our study male to female ratio was 2/1, and most cases belonged to a mild degree. In prenatal, 81% of sonographic reports were SFU grade 1, 44% mild degree APD, and 74% were UTD-A1.…”

Section: Discussionsupporting

confidence: 47%

Antenatal hydronephrosis: role of different sonographic approaches in predicting prognosis

Mohammadjafari

jafari

Abedi

et al. 2023

Preprint

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Background: Antenatal hydronephrosis (AH) is a common finding in prenatal assessment. We assessed and compared society of fetal urology ( SFU) ,anteroposterior pelvic diameter ( APD) and, urinary tract dilation ( UTD) classification criteria in predicting prognosis . Material and methods: We retrospectively analyzed neonates with a history of antenal hydronephrosis.We analyzed relation between each of three classification ways with etiologic diagnosis and prognosis of AH. Prognosis was classified as four grades, from transient hydronephrosis ( Grade 1) Grade 4 as severe kidney involvemevt or any need to surgery. Results : We enroled 290 neonates with a mean age of 16.4 ±9.0 days, 33% were female , One third had severe VUR , severe obstruction observed in 19 (22%) patients, 40% had transient hydronephrosis, 26 (9%) need to surgery. Only antenatal SFU grading showed significant relation with severe obstruction and only Postnatal SFU grading was related to severity of VUR. The highest sensitivity was ; prenatal SFU-1 (100%) , postnatal SFU-1 (98%) for VUR presence ; prenatal and postnatal SFU-1 (100%) for surgery. The highest specificity was ; prenatal SFU-4 (96%) , postnatal UTD-P3 (73%) for VUR presence; prenatal SFU-4(99%) and postnatal SFU-4 (94%) for surgery . Conclusion: There are no reliable prenatal sonographic finding to predict VUR or severe UPJO , SFU grading in postnatal period can predict VUR with a low sensitivity and specificity. All three classification systems have good ability to evaluate prognostic items such as need to surgery.

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Section: Discussionsupporting

confidence: 47%

Antenatal hydronephrosis: role of different sonographic approaches in predicting prognosis

Mohammadjafari

jafari

Abedi

et al. 2023

Preprint

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“…The persistence rate was significantly higher in UTD-A2 and 3 than in UTD-A1. 13 In this study, the male-to-female ratio was 2:1, and most patients indicated a mild degree based on all three criteria. In the prenatal group, 81% of the sonography reports were SFU grade 1, 44% were mild APD, and 74% were UTD-A1.…”

Section: Discussionmentioning

confidence: 54%

The Role of Varied Sonographic Criteria for Predicting Treatment and Prognosis of Antenatal Hydronephrosis: A Retrospective Cohort Study

Jafari,

Abedi,

Jafari Sarouei

et al. 2024

Journal of Diagnostic Medical Sonography

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Objective: This study aimed to compare the Society of Fetal Urology (SFU) guidelines, the anteroposterior pelvic diameter (APD), and the urinary tract dilation (UTD) classification criteria for predicting the prognosis of antenatal hydronephrosis (AH). Materials and Methods: This was a retrospective analysis of the relationship among the three classification criteria and their contribution to the diagnosis and prognosis of possible AH in a cohort of neonates. Results: This study was a retrospective review of 290 neonates. The mean age was 16.4 ± 9.0 days, and 33% of the study population comprised female babies. An image review demonstrated that 35% of the patients had severe vesicoureteral reflux (VUR), 22% exhibited severe obstruction, 40% had transient hydronephrosis, and 9% required surgery. The antenatal SFU grading criteria demonstrated a significant relationship with severe obstruction, and the postnatal SFU grading was related to the severity of VUR. The highest sensitivity for the presence of VUR for surgical intervention was obtained for prenatal SFU-1 (100%). The highest specificity was for prenatal SFU-4 (96%) for the presence of VUR, prenatal SFU-4 (99%), and postnatal SFU-4 (94%) for surgical intervention. Conclusion: No reliable sonographic findings were found to predict VUR or severe ureteropelvic junction obstruction. The SFU grading during the postnatal period may predict VUR with low sensitivity and specificity. However, all three classification criteria contributed to the evaluation of the need for treatment in this cohort.

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“…Extensive postnatal investigation was proposed to be limited to those with moderate or severe dilatation. The UTD classification has been evaluated in several studies and has shown an accurate precision in detecting postnatal CAKUT, the need for surgery [ 14 – 16 ], and chronic kidney disease [ 17 , 18 ]. Updated recommendations were published in 2022 [ 19 ].…”

Section: Definition and Grading Of Utdmentioning

confidence: 99%

Antenatally detected urinary tract dilatation: long-term outcome

Herthelius

2023

Pediatr Nephrol

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This review provides updated knowledge on the long-term outcomes among children with antenatally diagnosed urinary tract dilatation (UTD), previously often referred to as antenatal hydronephrosis. Different definitions of UTD exist, which makes comparison between studies and generalized conclusions difficult. Roughly, one-third of antenatally diagnosed UTD, defined as a renal pelvis anterior posterior diameter (APD) of ≥ 4 mm in the second trimester and/or ≥ 7 mm in the third trimester, will resolve before birth, another third will resolve within the first years of life, and in the remaining cases, UTD will persist or a congenital abnormality (CAKUT) will be diagnosed postnatally. The risk of a postnatal CAKUT diagnosis increases with the degree of prenatal and postnatal dilatation, except for vesicoureteral reflux (VUR), which cannot be predicted from the degree of UTD. Urinary tract infections (UTIs) occur in 7–14% of children with UTD during the first years of life. The risk of UTI is higher in children with traditional risk factors for UTI, such as dilated VUR, hydroureteronephrosis, female gender, and intact foreskin. Continuous antibiotic prophylaxis may be considered in selected patients during the first years of life. In long-term follow-ups, permanent kidney damage is diagnosed in approximately 40% of children with moderate or severe UTD, but hypertension, proteinuria, and/or reduced eGFR are uncommon (0–5%). In children with mild UTD, the long-term outcome is excellent, and these children should not be subjected to unnecessary examinations and/or follow-up.

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Frequency and prediction of persistent urinary tract dilation in third trimester and postnatal urinary tract dilation in infants following diagnosis in second trimester

Cited by 7 publications

References 29 publications

Antenatal hydronephrosis: role of different sonographic approaches in predicting prognosis

Antenatal hydronephrosis: role of different sonographic approaches in predicting prognosis

The Role of Varied Sonographic Criteria for Predicting Treatment and Prognosis of Antenatal Hydronephrosis: A Retrospective Cohort Study

Antenatally detected urinary tract dilatation: long-term outcome

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