Objective-To evaluate screening for abnormalities of the fetal renal tract by ultrasonography and to determine the incidence of such abnormalities in a population.Design-A 12 month prospective population study. Foliow up of infants to between 9 and 18 months.Setting-A district general hospital. Participants-6292 Pregnant women reaching 28 weeks' gestation within the study period.Interventions-Antenatal ultrasound scanning was offered to all of the women. Babies in whom an abnormality of the renal tract had been detected antenatally underwent ultrasound scanning at the end of the first week. If the abnormality was confirmed contrast radiography was performed.End point-Confirmation of suspected renal abnormality by postnatal investigations. Detection of abnormality in children thought to be normal antenatally.Measurements and main results-Of the 92 babies who had abnormal antenatal scans, 42 had abnormalities confirmed postnatally. Four of them died and 21 had had or were awaiting an operation at 18 months' follow up. Seven children had renal abnormalities that were missed antenataliy. The incidence of abnormalities detected by screening antenatally was 0-65%, and the overall incidence at 18 months' follow up was 076%.Conclusions-The incidence of structural renal abnormalities in babies is higher than reported previously. Antenatal ultrasonography is an effective way of detecting such abnormalities.

Objective-To evaluate screening for abnormalities of the fetal renal tract by ultrasonography and to determine the incidence of such abnormalities in a population.Design-A 12 month prospective population study. Foliow up of infants to between 9 and 18 months.Setting-A district general hospital. Participants-6292 Pregnant women reaching 28 weeks' gestation within the study period.Interventions-Antenatal ultrasound scanning was offered to all of the women. Babies in whom an abnormality of the renal tract had been detected antenatally underwent ultrasound scanning at the end of the first week. If the abnormality was confirmed contrast radiography was performed.End point-Confirmation of suspected renal abnormality by postnatal investigations. Detection of abnormality in children thought to be normal antenatally.Measurements and main results-Of the 92 babies who had abnormal antenatal scans, 42 had abnormalities confirmed postnatally. Four of them died and 21 had had or were awaiting an operation at 18 months' follow up. Seven children had renal abnormalities that were missed antenataliy. The incidence of abnormalities detected by screening antenatally was 0-65%, and the overall incidence at 18 months' follow up was 076%.Conclusions-The incidence of structural renal abnormalities in babies is higher than reported previously. Antenatal ultrasonography is an effective way of detecting such abnormalities.

Over three years all infants in this hospital found to have an abnormality of the urinary tract on antenatal scanning were followed up after delivery with contrast radiography. Disease of the renal tract was confirmed in 17 of 20 infants. Of the 15 survivors, 12 underwent surgery in the first year of life.

Despite being a rare neoplasm, yolk sac tumour is the commonest of all childhood testicular malignancies. Early detection and treatment result in an excellent prognosis. Ultrasound can play a valuable role in differentiating benign and malignant forms of testicular pathology at any age. Detailed description of ultrasonic appearances of specific tumours with pathological correlation is, however, as yet incomplete. A 13-month-old child was admitted with a scrotal swelling that was thought by the mother to have been present since birth but had increased considerably in size over the previous 4 weeks. Clinical examination revealed a large, tense, non-tender swelling which did not transilluminate. A complicated hydrocele was suspected.

A 12-month prospective population study of antenatal patients was undertaken in a large district general hospital to assess ultrasound scanning in late pregnancy for the detection of non-lethal fetal renal abnormalities. The rate of false-negative antenatal scans during the study period was also assessed. Both 18-20 and 28-32 weeks' gestational scans were performed on 6497 pregnant women. Forty fetuses with a suspected abnormality were referred for postnatal examination and 29 neonates were found to have renal abnormalities. Of these, 21 were significant and eight were likely to be extrarenal pelves. In six, there was evidence of an abnormality at the early scan. Nine children, seven with reflux, presented within the study period, all with preceding normal antenatal scans. The incidence (0.46 per cent) of structural renal abnormalities is similar to that reported previously. A late scan is necessary for the antenatal detection of non-lethal renal abnormalities.