Routine fetal genitourinary tract screening.

Abstract

To evaluate routine fetal genitourinary tract obstetrical ultrasound screening, and to determine what size renal pelvis is indicative of significant renal disease, we reviewed 4,832 examinations, which had been performed over 2 years, of 3,530 consecutive obstetrical patients. Any fetus that had a renal pelvis greater than 5 mm or a definable cystic area was identified for follow-up. The fetuses of 39 patients (1.1%) who underwent 112 examinations fulfilled these criteria and constitute the basis of this report. A variety of examination criteria were recorded and analyzed in relationship to the follow-up, which ranged from 2-3 days to 21 months. The fetuses of the 39 patients were grouped into three categories: those with renal pelves between 5 and 9 mm in size; those with renal pelves larger than 10 mm; and those with cystic abnormalities. Those with renal pelves larger than 10 mm had either an obstructing lesion or exceptional extrarenal pelves. The clinical and pathologic aspects of these three groups are detailed, discussed, and analyzed. Criteria for significant fetal renal hydronephrosis and aspects of a loculated appearance are given.

Antenatal Diagnosis of Upper Urinary Tract Dilation by Ultrasonography

“…According to these criteria, the incidence of urinary tract malformations was 0.60%, while the positive predictive value was 13.7%. These values are similar to those reported in the literature, although the incidence is some what higher than the previously reported pro portions of 0.16-0.55% [1,2,4,8] (table 3). On the other hand, in our experience, 4.1 % of the screened fetuses underwent postnatal evaluation, while this percentage in other se ries is lower and varies between 0.37 and 1.92% [1,2,4,8].…”

“…The advent of routine ultrasound scanning of pregnant women for fetal malformations has led to the detection of an increasing number of fetal urinary tract abnormalities, in cluding 57-87% obstructive or dilated mal formations [1][2][3][4], Prenatal ultrasonographic examination can detect obstructive uropathy in fetuses who could potentially benefit from KARGER E-Mail karger(S^karger.ch F a x + 41 61 306 12 34 intervention in utero. Furthermore, prenatal diagnosis may enable the postnatal initiation of a preventive pediatric follow-up and of antibiotic prophylaxis in less severe unilateral or bilateral forms [5], Ultrasound, however, often detects a sonolucent region in the hilum of the fetal kidney, and the threshold dimen sion for the detection of a pathological dila tion of the renal pelvis is still controversial [6][7][8][9][10][11].…”

Effect of Pregnancy on Rabbit Urinary Bladder Physiology

“…In one series, urologic abnormalities were detected in 1 of every 750 examinations performed with hydrone phrosis being the most common finding [1], Finding hydronephrosis on an antenatal ul trasound poses a challenge for the obste trician and the pediatric urologist who is often consulted. For the patient with unilat eral hydronephrosis diagnosed by antenatal hydronephrosis, the current urologic recom mendation is observation with evaluation after delivery [2], While major advances have been made in the techniques of open and percutaneous fetal surgery, these same investigators are the first to point out that the number of candidates for such interven tion is small [3].…”

Fetal hydronephrosis: postnatal management and follow up

“…Em duas grandes séries publicadas, os autores relatam que apenas uma pelve renal com o diâmetro ântero-posterior maior que 10 mm seria preditiva de anomalia significativa do trato uriná-rio 11,12 . No entanto, pesquisa de refluxo vésico-ureteral pela cisto-uretrografia miccional não foi realizada rotineiramente.…”