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Fetal pyelectasis: is it always "physiologic"?
- Source :
-
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 1995 Oct; Vol. 173 (4), pp. 1263-6. - Publication Year :
- 1995
-
Abstract
- Objective: Our purpose was to determine the degree of fetal pyelectasis predictive of neonatal renal pathologic processes.<br />Study Design: Eighty-four cases of pyelectasis were identified during the study period (1989 through 1993). Fetuses with anteroposterior diameter of the renal pelvis > or = 4 mm before 33 weeks or > or = 7 mm after 33 weeks without caliectasis were included. Fetuses with an anteroposterior diameter of > 10 mm were excluded. Postnatal evaluation included renal sonogram, voiding cystourethrogram, and renal flow and function studies.<br />Results: Sixteen cases were excluded because of incomplete postnatal workup. Renal pathologic processes were found in 30 of 68 (44%) at birth; the most common were ureteropelvic junction obstruction (37%) and vesicoureteral reflux (33%). Only four cases required surgical intervention (13%), and the remaining 87% were managed conservatively. A normal urinary tract was found in 25% of the infants and the remaining 21 of 68 (31%) had regression of pyelectasis before birth. Fetuses with a dilated anteroposterior diameter > or = 8 mm after 28 weeks' gestation were found to have renal pathologic features in two of three of the cases, with sensitivity, specificity, and positive and negative predictive values of 87%, 41%, 66.7% and 70%, respectively.<br />Conclusion: Fetuses with an anteroposterior diameter of the renal pelvis > or = 8 mm after 28 weeks' gestation require appropriate urologic evaluation after birth.
- Subjects :
- Dilatation, Pathologic diagnostic imaging
Female
Humans
Infant, Newborn
Kidney Pelvis
Male
Predictive Value of Tests
Pregnancy
Sensitivity and Specificity
Ultrasonography, Prenatal
Ureteral Obstruction diagnostic imaging
Vesico-Ureteral Reflux diagnostic imaging
Fetal Diseases diagnostic imaging
Kidney Diseases diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9378
- Volume :
- 173
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of obstetrics and gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 7485334
- Full Text :
- https://doi.org/10.1016/0002-9378(95)91367-x