First and early second‐trimester diagnosis of fetal urinary tract anomalies using transvaginal sonography

Bronshtein, Moshe; Yoffe, N; Brandes, Joseph M.; Blumenfeld, Zeev

doi:10.1002/pd.1970101005

Cited by 72 publications

(40 citation statements)

References 13 publications

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“…[5][6][7] This was true for 115 (47%) of the 245 cases registered at the National Multicystic Kidney Registry. 8 Indeed, the most common reason for referral of the patients in the present study was a prenatal diagnosis of a renal abnormality.…”

Section: Discussionmentioning

confidence: 96%

Involution Rate of Multicystic Renal Dysplasia

et al. 1998

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ABSTRACT. Objective. To document the involution rate and long-term results of management of multicystic dysplastic kidney.Materials and Methods. Data were collected retrospectively for all 23 infants (16 boys) with multicystic dysplastic kidney who were treated at our center over the last 19 years (1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995). The diagnosis was based on prenatal ultrasound in 18 patients and on palpable abdominal mass in 5, and confirmed in all patients by postnatal ultrasound and radioisotope scan. Voiding cystography was performed in 18 patients to exclude vesicoureteral reflux. Mean follow-up was 46 months (range, 3 months to 5 years) and included serum creatinine measurements and renal ultrasonography.Results. Two groups of patients were identified. Ten (43.6%) with other urologic abnormalities (group A) and 13 patients without other urologic abnormalities (group B). Vesicoureteral reflux was observed in 4 patients. Nephrectomy was performed in 4 patients, all from group B. The other 19 patients were treated conservatively. Complete involution was observed in 8 patients in group A and 6 in group B after a mean follow-up period of 9.2 and 10 months, respectively. Two patients, 1 from each group, later underwent nephrectomy not because of no involution but because of an increase in the size of the kidney involved.Conclusion. Patients with multicystic renal dysplasia have significant associated urologic malformations, and the natural history of the disease is unpredictable. All patients require appropriate investigation of the urinary tract and long-term follow-up.The most outstanding finding of the study is the much higher involution rate of multicystic renal dysplasia and the rate of associated urologic abnormalities than that reported in the literature. Surgery remains an option for the patients in the absence of no involution. Pediatrics 1998;102(6). URL: http://www.pediatrics.org/cgi/content/ full/102/6/e73; multicystic dysplastic kidney, surgery, conservative.ABBREVIATIONS. MCRD, multicystic renal dysplasia; UPJ, ureteropelvic junction; VUR, vesicoureteral reflux; UVJ, ureterovesical junction. M ulticystic renal dysplasia (MCRD) is the most common form of cystic disease of the kidney in childhood.1 The increasingly widespread use of prenatal diagnostic techniques has revealed that MCRD is apparently even more prevalent than had been assumed. 2 The association of hypertension, malignancy, and incomplete involution in MCRD mandate long-term follow-up, and much controversy has surrounded the question of whether nephrectomy is indicated routinely on diagnosis. 3,4 To assess the natural history of this condition and, for purposes of proper management, the associated urinary malformations, we conducted a 19-year retrospective study of all infants with MCRD who had been diagnosed and treated in our tertiary care medical center. MATERIALS AND METHODSWe reviewed the charts and radiologic records of the 25 patients with MCRD who w...

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Section: Discussionmentioning

confidence: 96%

Involution Rate of Multicystic Renal Dysplasia

et al. 1998

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“…Indeed in one reported case in which the bladder measured 30 mm, vesicocentesis was deferred until 22 weeks by which time bilateral renal damage had already occurred 9 . In another three untreated cases with bladder diameters of 30 mm, intrauterine death or progressive complications of obstructive uropathy occurred 5,10,11 . It has been shown that the survival rate following second-trimester vesicoamniotic shunt placement for obstructive uropathy ranges from 41 to 70% depending on etiology 12 with 36% of cases developing renal failure necessitating transplantation 13 .…”

Section: Vesicocentesis At 10-14 Weeks Carroll Et Almentioning

confidence: 99%

“…Depending on the fluid volume, fetal karyotype may be determined either from the bladder aspirate or from simultaneous amniocentesis. In cases of bladder outlet obstruction at 10-14 weeks there should be sufficient amniotic fluid volume for karyotyping because the quantitative contribution of fetal urine to the amniotic fluid volume is minimal before 16 weeks' gestation 10 . However, because of the potential benefits of early vesicocentesis, we think that if intervention is to be tried it should not be deferred until karyotype results are available.…”

Section: Vesicocentesis At 10-14 Weeks Carroll Et Almentioning

confidence: 99%

Vesicocentesis at 10–14 weeks of gestation for treatment of fetal megacystis

Carroll

Soothill

Tizard

et al. 2001

Ultrasound in Obstet & Gyne

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“…Evaluation of fetal kidney biometry must be included in the guidelines for an early transvaginal scan and, since the first sign of malformation could be an enlarged kidney [2], measurement of the kidney parameters is recommended in all cases.…”

Section: Introductionmentioning

confidence: 99%

Transvaginal Sonographic Fetal Biparietal Diameter/Kidney Length Ratio in Early Pregnancy as a Screening Tool for Renal Malformations

Guariglia

Rosati²

1998

Fetal Diagn Ther

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Objective: The aim of the study was to produce by 7.0 MHz high resolution transvaginal scan early in pregnancy normal values of biparietal diameter/kidney length ratio that can be used as reference ranges. Methods: In this prospective cross-sectional study, a transvaginal high-resolution sonography was performed between 11 and 16 weeks’ gestation in 807 pregnant women with a history of regular cycles, singleton pregnancies and absence of fetal malformations. Measurements of kidney length and biparietal diameter were obtained in all cases and biparietal diameter/kidney length ratio was plotted against gestational age. Results: The values of biparietal diameter/kidney length ratio were found to be fairly constant throughout the period evaluated. Conclusion: Our results indicate that this new age-independent ratio can be useful in the early detection of some fetal kidney malformations affecting normal growth.

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First and early second‐trimester diagnosis of fetal urinary tract anomalies using transvaginal sonography

Cited by 72 publications

References 13 publications

Involution Rate of Multicystic Renal Dysplasia

Involution Rate of Multicystic Renal Dysplasia

Vesicocentesis at 10–14 weeks of gestation for treatment of fetal megacystis

Transvaginal Sonographic Fetal Biparietal Diameter/Kidney Length Ratio in Early Pregnancy as a Screening Tool for Renal Malformations

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