Abstract:A high correlation between prenatal ultrasound and postmortem investigations was observed. Conventional autopsy remains the gold standard to reveal additional major and minor malformations, leading to a correct final diagnosis. The added value of virtual necropsy for renal pathology was limited.
“…In this issue of Pediatric Nephrology Gebäck et al, in their prolonged follow-up of this group, find that the kidney function had deteriorated since the previous follow-up [1]. The GFR in women with bilateral renal scarring had gone down from 93 ml/min/m 2 to 81 ml/min/m 2 (P=0.01), while it had remained stable in those without any scars.…”
Section: Kidney Functionmentioning
confidence: 79%
“…With this paper and a recent paper on long-term follow-up of blood pressure [1,2], the authors extend our knowledge on the long-term effects of renal scarring in a major way. The group in Gothenburg, Sweden, have a long-standing interest in UTI and have published numerous papers on many different aspects of the disease.…”
mentioning
confidence: 90%
“…These women were monitored for renal scarring, glomerular filtration rate and blood pressure at a median follow-up of 14.8 (5.9-32.2) years after their first UTI [4]. Gebäck now presents a further 20-year follow-up with a total median follow-up time of 35 years (range 23-50) [1]. This present study was performed between 2001 and 2004 and we can thus hope for further follow-up of these women who were born 50 to 60 years ago.…”
In this issue of Pediatric Nephrology, Gebäck et al. from Gothenburg, Sweden, show that after a mean follow-up after childhood urinary tract infection of 41 years, kidney function decreases from a mean of 93 ml/min/1.73m(2) to 81 ml/min/1.73m(2). This was found in women with severe bilateral renal scarring. They had experienced their UTI during childhood in the 1950s and 1960s and had been drawn from a population-based cohort of more than 1,000 children. A previous paper on this same group of women had shown a higher systolic blood pressure of 3 mmHg during the day and 5 mmHg during the night compared with a control group. This contrasted with a follow-up study published earlier by the same group on two different cohorts in which no impairment of kidney function or increase in hypertension could be found. The present follow-up time was 13 years longer than that of any previous studies. Data on the long-term outcome of children who have had one or several urine infections is very important, as the fear of long-term complications has been driving the extensive investigations to which these children have traditionally been subjected. Further population-based follow-up data can help us to outline modern guidance on imaging after UTI.
“…In this issue of Pediatric Nephrology Gebäck et al, in their prolonged follow-up of this group, find that the kidney function had deteriorated since the previous follow-up [1]. The GFR in women with bilateral renal scarring had gone down from 93 ml/min/m 2 to 81 ml/min/m 2 (P=0.01), while it had remained stable in those without any scars.…”
Section: Kidney Functionmentioning
confidence: 79%
“…With this paper and a recent paper on long-term follow-up of blood pressure [1,2], the authors extend our knowledge on the long-term effects of renal scarring in a major way. The group in Gothenburg, Sweden, have a long-standing interest in UTI and have published numerous papers on many different aspects of the disease.…”
mentioning
confidence: 90%
“…These women were monitored for renal scarring, glomerular filtration rate and blood pressure at a median follow-up of 14.8 (5.9-32.2) years after their first UTI [4]. Gebäck now presents a further 20-year follow-up with a total median follow-up time of 35 years (range 23-50) [1]. This present study was performed between 2001 and 2004 and we can thus hope for further follow-up of these women who were born 50 to 60 years ago.…”
In this issue of Pediatric Nephrology, Gebäck et al. from Gothenburg, Sweden, show that after a mean follow-up after childhood urinary tract infection of 41 years, kidney function decreases from a mean of 93 ml/min/1.73m(2) to 81 ml/min/1.73m(2). This was found in women with severe bilateral renal scarring. They had experienced their UTI during childhood in the 1950s and 1960s and had been drawn from a population-based cohort of more than 1,000 children. A previous paper on this same group of women had shown a higher systolic blood pressure of 3 mmHg during the day and 5 mmHg during the night compared with a control group. This contrasted with a follow-up study published earlier by the same group on two different cohorts in which no impairment of kidney function or increase in hypertension could be found. The present follow-up time was 13 years longer than that of any previous studies. Data on the long-term outcome of children who have had one or several urine infections is very important, as the fear of long-term complications has been driving the extensive investigations to which these children have traditionally been subjected. Further population-based follow-up data can help us to outline modern guidance on imaging after UTI.
“…22). A prenatal history of oligohydramnios may be present, and non-visualisation of the urinary bladder at prenatal ultrasound has been reported as a marker for significant renal pathology and poor foetal survival [47, 48]. Fig.…”
There has been an increasing demand and interest in post-mortem imaging techniques, either as an adjunct or replacement for the conventional invasive autopsy. Post-mortem ultrasound (PMUS) is easily accessible and more affordable than other cross-sectional imaging modalities and allows visualisation of normal anatomical structures of the brain, thorax and abdomen in perinatal cases. The lack of aeration of post-mortem foetal lungs provides a good sonographic window for assessment of the heart and normal pulmonary lobulation, in contrast to live neonates.
In a previous article within this journal, we published a practical approach to conducting a comprehensive PMUS examination. This covered the basic principles behind why post-mortem imaging is performed, helpful techniques for obtaining optimal PMUS images, and the expected normal post-mortem changes seen in perinatal deaths. In this article, we build upon this by focusing on commonly encountered pathologies on PMUS and compare these to autopsy and other post-mortem imaging modalities.
“…Predictors of unfavorable outcome identified by ultrasound include early gestational age at diagnosis, low amniotic fluid volume, cystic or echogenic renal parenchyma, and bilateral renal involvement . Based on these ultrasound parameters, fetuses with an unfavorable prognosis can be identified, but low specificity of these characteristics may lead to unnecessary termination of pregnancy . In less severe cases of renal impairment or unilateral involvement, ultrasound features are even more inaccurate to predict postnatal renal function.…”
Low PSV RA might have a predictive value for diagnosing a nonfunctioning kidney in fetuses with a SFK. We demonstrated a higher PSV RA and larger renal volume in the SFK compared with healthy kidneys.
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