Sonographic analysis of the fetus with ureteropelvic junction obstruction

Kleiner, B.; Pw, Callen; Ra, Filly

doi:10.2214/ajr.148.2.359

Cited by 50 publications

(14 citation statements)

References 4 publications

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“…Predominantly, these were cases with severe renal outflow obstruction and unilateral cystic kidney diseases. However, in older studies, published in the late 1980s, the same association was noticed before [15,16]. An impairment of the renal concentrating ability may be responsible for the increased amniotic fluid volume in these cases.…”

Section: Discussionsupporting

confidence: 63%

Idiopathic Polyhydramnios and Postnatal Abnormalities

et al. 2012

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Objective: To investigate the proportion and type of fetal anomalies that are associated with polyhydramnios and to examine whether in cases with idiopathic polyhydramnios during the course of pregnancy and fetal anomalies only diagnosed after birth, antenatal characteristics differ. Methods: This was a retrospective study involving all pregnancies with polyhydramnios defined by a deepest pool of amniotic fluid ≥8 cm and a detailed ultrasound examination, a 75 g glucose tolerance test and a TORCH serology. Results: Between 2004 and 2010, 272 pregnancies fulfilled the inclusion criteria. In 89 (32.7%) and 65 (23.9%) cases, there was a fetal anomaly or diabetes. In 118 (43.4%) pregnancies, polyhydramnios was classified as idiopathic. In 11 (9.3%) of the 118 fetuses, an anomaly was found after birth, mainly gastrointestinal atresia. In these cases, median deepest pool of amniotic fluid was 9.6 cm, and median estimated fetal weight was at the 69th centile, whereas in cases without anomalies diagnosed after birth, median deepest pool was 9.0 cm and median estimated fetal weight at the 90th centile (Mann-Whitney U test: deepest pool p = 0.116, and estimated fetal weight centile p = 0.377). There was also no difference in the maternal and gestational age distribution of these cases (Mann-Whitney U test: maternal age p = 0.293, and gestational age p = 0.499). Conclusion: In about 40% of pregnancies, polyhydramnios remains unexplained during the course of pregnancy. In 10% of these cases, an anomaly will only be found after birth. In this group, antenatal characteristics such as amniotic fluid volume, estimated fetal weight or gestational and maternal age at the time of diagnosis do not help to detect these anomalies before birth.

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Section: Discussionsupporting

confidence: 63%

Idiopathic Polyhydramnios and Postnatal Abnormalities

et al. 2012

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“…Antenatal and postnatal USG are diagnostic and show disproportionately dilated renal pelvis with mild dilatation of calices and non dilated ureters [40] . DTPA is performed to assess the degree of obstruction and split renal function.…”

mentioning

confidence: 99%

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

Ramanathan¹,

Kumar²,

Khanna³

et al. 2016

WJR

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Congenital abnormalities of the kidney and urinary tract (CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis (bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number (agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography (US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.

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“…For example, it has been proposed that renal obstruction may affect the ability of the kidney to concentrate, resulting in an increase in urinary output and subsequent polyhydramnios. 4 Because renal function is generally not affected by megacalycosis, other potential causes of polyhydramnios must be considered. The massive size of the calyx in this case was sufficient to elevate the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Sonographic Findings of Fetal Megacalycosis

Hill

Macpherson

Romano

et al. 2002

J of Ultrasound Medicine

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egacalycosis refers to dilatation of the renal calyces without evidence of distension of the renal pelvis or ureter. 1 It characteristically involves 1 kidney and does not alter renal function. Because obstructive urinary tract lesions are common, both the American Institute of Ultrasound in Medicine 2 and the American College of Radiology have included images of the fetal kidneys in their second-and third-trimester fetal examination guidelines. With severe obstruction the renal architecture becomes distorted and difficult to see. In this instance it may be impossible to distinguish between a dilated renal pelvis and a dilated calyx. Institutional Review Board approval was obtained to report the following case.

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Sonographic analysis of the fetus with ureteropelvic junction obstruction

Cited by 50 publications

References 4 publications

Idiopathic Polyhydramnios and Postnatal Abnormalities

Idiopathic Polyhydramnios and Postnatal Abnormalities

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

Prenatal Sonographic Findings of Fetal Megacalycosis

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