Long-term clinical outcome of infants with mild and moderate fetal pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies

Ismaïli, Khalid; Avni, Fred E.; Wissing, Karl Martin; Hall, Michelle

doi:10.1016/j.jpeds.2004.02.035

Cited by 74 publications

(87 citation statements)

References 13 publications

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“…reports regarding gender distribution of vur patients vary. 10,14,16,21,[30][31][32][33] However, other authors have observed that the male:female ratio in children with reflux is dynamic across different age groups, ranging from a male preponderance in infants to a clear female preponderance in older children. 30,34 it is also important to recognize that the calculated ratio between the sexes is dependent upon the method of ascertainment.…”

Section: Vur Is a Complex Diseasementioning

confidence: 99%

Genetics of vesicoureteral reflux

et al. 2011

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| Primary vesicoureteral reflux (VUR) is the most common urological anomaly in children, affecting 1-2% of the pediatric population and 30-40% of children presenting with urinary tract infections (UTIs). Refluxassociated nephropathy is a major cause of childhood hypertension and chronic renal failure. The hereditary and familial nature of VUR is well recognized and several studies have reported that siblings of children with VUR have a higher incidence of reflux than the general pediatric population. Familial clustering of VUR implies that genetic factors have an important role in its pathogenesis, but no single major locus or gene for VUR has yet been identified and most researchers now acknowledge that VUR is genetically heterogeneous. Improvements in genome-scan techniques and continuously increasing knowledge of the genetic basis of VUR should help us to further understand its pathogenesis.

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Section: Vur Is a Complex Diseasementioning

confidence: 99%

Genetics of vesicoureteral reflux

et al. 2011

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“…[1][2][3][4] The majority of these fetuses recover spontaneously but approximately 40% require postnatal follow-up, and in half of these cases, medical or surgical intervention was needed to prevent significant renal damage. The spectrum of genitourinary abnormalities detected antenatally is varied but the majority of patients have ANH.…”

Section: Introductionmentioning

confidence: 99%

“…5 It is commonly accepted that no specific etiology can be identified in 48% of ANH cases. [1][2][3][4][5] Physiologic changes are seen in 15%, ureteropelvic and ureterovesical junction obstructions account for 11% of the cases, 9% have vesicoureteral reflux, 4% have unilateral or bilateral megaloureters, 2% of all cases have multicystic dysplastic kidney (MCDK) and 1% have ureterocele. 1,3,6 Regardless of the cause, it is expected that about half of the ANH cases will resolve before delivery or during the first year of life.…”

Section: Introductionmentioning

confidence: 99%

“…1,3,6 Regardless of the cause, it is expected that about half of the ANH cases will resolve before delivery or during the first year of life. 2,6 For the other half there will be a need for postnatal follow-up as persistent uropathy is expected to occur in 12% of mild, 45% of moderate and 88% of severe ANH cases. 1,3,4,7 -9 Successful management of ANH requires dependable fetal surveillance, prompt neonatal evaluation, including sonography, and when indicated, referral to a pediatric urology service for further consultation and/or treatment.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4]7 After 34 weeks of gestation, severity of ANH was defined as mild (7 to 9 mm), moderate (10 to 14 mm) or severe (X15 mm).…”

Section: Introductionmentioning

confidence: 99%

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Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

et al. 2009

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Objective: To examine our experience with ANH and to determine the success of our postnatal follow-up program.Study Design: Charts of mothers and infants seen (2004 to 2008) at our Regional Perinatal Center were reviewed retrospectively. ANH was defined during the third trimester by anterior pelvic diameters as follows: mild 7 to 9, moderate 10 to 14 or severe X15 mm. Fetuses with multicystic dysplastic kidney (MCDK) were included. Result:Screening of approximately 15 000 ultrasound (US) reports identified 268 fetuses with ANH. After prenatal US surveillance, 88 (33%) fetuses had resolved, while 180 (67%) required postnatal follow-up. These 180 fetuses were diagnosed with mild 38 (21%), moderate 83 (46%) and severe 19 (11%) ANH, uni or bilateral hydroureters 12 (7%), MCDK 19 (10%) and miscellaneous 9 (5%). Postnatal follow-up was successfully established for 75% of infants with hydroureters, 68% for those with MCDK and for 37% of infants with mild, 53% with moderate and 58% with severe ANH. Factors commonly known to influence compliance were not found more frequently among the 91 infants who were lost to follow-up. The only positive predictor for postnatal follow-up was a prenatal consultation with the pediatric urologist. 1-4 The majority of these fetuses recover spontaneously but approximately 40% require postnatal follow-up, and in half of these cases, medical or surgical intervention was needed to prevent significant renal damage. The spectrum of genitourinary abnormalities detected antenatally is varied but the majority of patients have ANH.5 It is commonly accepted that no specific etiology can be identified in 48% of ANH cases.1-5 Physiologic changes are seen in 15%, ureteropelvic and ureterovesical junction obstructions account for 11% of the cases, 9% have vesicoureteral reflux, 4% have unilateral or bilateral megaloureters, 2% of all cases have multicystic dysplastic kidney (MCDK) and 1% have ureterocele. 1,3,6 Regardless of the cause, it is expected that about half of the ANH cases will resolve before delivery or during the first year of life. 2,6 For the other half there will be a need for postnatal follow-up as persistent uropathy is expected to occur in 12% of mild, 45% of moderate and 88% of severe ANH cases.

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Postnatal longitudinal evaluation of children diagnosed with prenatal hydronephrosis: insights in natural history and referral pattern

et al. 2012

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Despite prenatal resolution totalizing 25%, pelvic dilatation persisted on first postnatal imaging in most cases, thus justifying postnatal ultrasound evaluation. Whereas most mild cases resolved spontaneously, a quarter of moderate and more than half of severe cases required surgery. Patients with postnatal imaging and referral had more severe PNH, which could result in overestimation of pathology.

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Long-term clinical outcome of infants with mild and moderate fetal pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies

Cited by 74 publications

References 13 publications

Genetics of vesicoureteral reflux

Genetics of vesicoureteral reflux

Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

Postnatal longitudinal evaluation of children diagnosed with prenatal hydronephrosis: insights in natural history and referral pattern

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