Original ArticlesLong-term clinical outcome of infants with mild and moderate fetal pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies∗☆
Section snippets
Methods
As part of a prospective study evaluating the results of systematic VCUG in infants with antenatally diagnosed renal pelvis dilatation,10 we documented the clinical and imaging evolution of these children during 2 years of follow-up. This prospective cohort study was conducted in two hospitals in Brussels (without bias in referral pattern). Prenatal ultrasound was performed once every trimester as part of a routine evaluation of pregnancy in an unselected population. All routine antenatal
Results
From October 1998 through October 2000, a prenatal diagnosis of mild to moderate renal pelvis dilatation was made in 258 of 5643 fetuses. Forty-five cases (17%) were excluded from the study because of incomplete postnatal data. The remaining 213 newborns (139 boys and 74 girls; male to female ratio, 1.88:1) were scheduled for investigation following the above protocol, and were followed prospectively for up to 2 years in our department of perinatal nephrology.
Discussion
For 20 years, obstetric ultrasound has been performed routinely during pregnancies in Europe. In Belgium, three sonographic examinations are performed, one in each trimester. This has led to the discovery of many fetal anomalies, and among them, upper renal tract dilatation represents one of the largest groups amenable to neonatal management.12
The current study highlights the importance of following up all cases of antenatal mild to moderate renal pelvis dilatation. Our results show that mild
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Cited by (111)
Pediatric Nephro-Urology: Overview and Updates in Diuretic Renal Scans and Renal Cortical Scintigraphy
2022, Seminars in Nuclear MedicineCitation Excerpt :Dilatation of the pelvicalyceal system with or without dilatation of the ureter can suggest underlying obstruction but frequently occurs without any physical obstruction to urine flow. Ureteropelvic junction stenosis occurs in 13% of antenatally diagnosed hydronephrosis4 Vesicoureteral reflux resolved intrauterine obstructions and flaccidity of the pelvis and ureter are common reasons for non-obstructive dilatation of the urinary tract5 Ultrasonography (US) is an excellent tool for pre and post-natal detection of hydronephrosis and hydroureteronephrosis, for monitoring spontaneous changes in the degree of dilatations overtime and for evaluation of surgical interventions.
Incidence of urinary tract infections in infants with antenatally diagnosed hydronephrosis—A retrospective single center study
2017, Journal of Pediatric SurgeryRenal development in the fetus and premature infant
2017, Seminars in Fetal and Neonatal MedicineFrequency of postnatal hydronephrosis in infants with a renal anterior-posterior pelvic diameter > 4 mm on midtrimester ultrasound
2015, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :There is no clear consensus on the follow up and management of mild or moderate hydronephrosis observed on antenatal ultrasound, although it is generally recommended that a postnatal evaluation be performed if the AP diameter of the renal pelvis exceeds 10 mm at any point in gestation [13]. Although a number of predictive algorithms have been developed, some studies have indicated that mild hydronephrosis that resolves during the course of a pregnancy may reoccur and progress, ultimately requiring treatment [14–16]. Thus, determining the occurrence of postnatal hydronephrosis based on the presence of antenatal renal pelvic dilatation may aid in identifying neonates in which an evaluation for causes of hydronephrosis is warranted.
Fetal uropathies: pre- and postnatal imaging, management and follow-up
2023, Pediatric Radiology
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Presented in part at the 12th Congress of the International Pediatric Nephrology Association, September 1-5, 2001, Seattle, Washington.
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The members of the Brussels Free University Perinatal Nephrology Study Group are listed in the Appendix.