Urinary tract dilatation in utero: classification and clinical applications.

Grignon, Andrée; Filion, R; Filiatrault, D; Robitaille, Pierre; Homsy, Yves; Boutin, Hervé; LeBlond, Richard F.

doi:10.1148/radiology.160.3.3526402

Cited by 267 publications

(136 citation statements)

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“…We undertook a systematic review and metaregression analysis of cohort studies that reported outcomes of fetal RPD, for fetuses with an RPD of Յ15 mm. The primary analyses were based on fetuses identified by routine fetal ultrasound screening (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Secondary analyses evaluated studies that included pregnancies referred for specialist obstetric/fetal medicine reasons (29 -34).…”

Section: To Screen or Not To Screen That Is The Question: Whether 'mentioning

confidence: 99%

“…Five hundred and six potentially relevant studies were identified, of which 18 met the inclusion criteria (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Two studies reported overlapping patient cohorts but different outcomes (27,28).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The earliest reported fetal ultrasound was at 14 wk of gestation (21). Most studies reported that postnatal scans were not performed within 2 d after birth (17,20,22,23,(27)(28)(29)(30)(31), which may be important because newborns are initially oliguric and false-negative results are common at this time: 4 studies did not specify the earliest age at postnatal ultrasound assessment (18,29,30,33).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Mild Fetal Renal Pelvis Dilatation—Much Ado About Nothing?

Hothi¹,

Wade²,

Gilbert³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background: Renal pelvis dilatation (RPD) occurs in 1% of fetuses. Severe RPD (>15 mm) is frequently associated with urinary tract pathology. For the majority with mild (5 to 9 mm) to moderate (10 to 15 mm) RPD, however, there is uncertainty about the risk of abnormalities and how much postnatal investigation is required.Study design: Systematic review of cohort studies of fetuses with RPD < 15 mm and metaregression to estimate risks of postnatal RPD, obstruction, and VUR.Results: Of 506 potentially relevant papers, 18 met the inclusion criteria. Risk of postnatal RPD increased with fetal RP size and earlier gestation. Odds ratios for postnatal RPD doubled per millimeter increase in fetal RP size: At 20 wk gestation, for example, 18% of fetuses with mean RP of 6 mm were estimated to have persistent postnatal RPD, compared with 95% of fetuses with 12 mm RPD, but risks were decreased by 16% to 18% per week of presentation gestation. Estimated risks of obstruction and VUR were substantially lower, particularly in the mild group such as the 6 mm example above: obstruction 2%, VUR 4%.Conclusions: Our novel risk estimates are useful for antenatal counseling at presentation. The low frequency of obstruction/ VUR in mild RPD raises questions over the most appropriate investigation of these cases but further data are required before establishing definitive postnatal management pathways. We suggest the need for a large prospective multicenter study to collect individual patient parameters/results and search for additional prognostic indicators.

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Section: To Screen or Not To Screen That Is The Question: Whether 'mentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Mild Fetal Renal Pelvis Dilatation—Much Ado About Nothing?

Hothi¹,

Wade²,

Gilbert³

et al. 2009

Clinical Journal of the American Society of Nephrology

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“…The posterior urethral valve is the most common cause of infravesical obstruction in boys, with an incidence of 1 in 4,000 to 25,000 children born alive [20] . The presence of a fetus with thick bladder wall, bilateral hydronephrosis, with or without renal dysplasia, and oligoamnios strongly suggests the prenatal diagnosis of posterior urethral valve.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Evaluation of Foetal Hydronephrosis

Verghes¹

2017

jmscr

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“…Em duas grandes séries publicadas, os autores relatam que apenas uma pelve renal com o diâmetro ântero-posterior maior que 10 mm seria preditiva de anomalia significativa do trato uriná-rio 11,12 . No entanto, pesquisa de refluxo vésico-ureteral pela cisto-uretrografia miccional não foi realizada rotineiramente.…”

Section: Discussionunclassified

Fetal hydronephrosis: postnatal management and follow up

Oliveira¹,

Cabral²,

Leite³

et al. 1997

J Pediatr (Rio J)

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ResumoObjetivos: O achado de hidronefrose fetal tem sido observado cada vez com maior freqüência, e é provável que, com a melhoria dos equipamentos ecográficos, essa observação seja crescente. Neste presente estudo, apresentamos uma avaliação de crianças portadoras de hidronefrose fetal, com o objetivo de analisar as causas mais freqüentes de hidronefrose fetal e a evolução a longo prazo.Métodos: Em um período de 13 anos, 148 crianças foram admitidas no estudo e submetidas a um protocolo previamente estabelecido: na admissão, era iniciada a quimioprofilaxia e procedida a avaliação de imagens do trato urinário, consistindo de realização de uretrocistografia miccional e ultra-som. Os estudos seqüenciais foram determinados pelos achados nessa avaliação inicial.Resultados: No neonato, o achado mais freqüente foi de obstrução de junção pielo-ureteral em 35 (24%) pacientes, seguido de hidronefrose não-obstrutiva em 26(18%). A mediana de seguimento foi de 38,7 meses. Em relação à função renal, 13 (8,8%) pacientes evoluíram para a insuficiência renal crônica, e 11 (7,4%), para o óbito no período seguimento. O mau prognóstico esteve associado à presença de obstrução uretral.Conclusões: A hidronefrose fetal é um indício de importantes anomalias do trato urinário e uma oportunidade de uma atuação em nível de prevenção secundária, evitando infecções urinárias e mantendo um fluxo urinário adequado nas crianças portadoras de uropatias. J. pediatr. (Rio J.). 1997; 73(4):252-258:hidronefrose, feto, ultra-som, uropatias, trato urinário. AbstractObjective: Fetal hydronephrosis is being detected with increasing frequency and probably this observation will increase as the quality of ultrasound equipment improves. This study evaluated etiology and postnatal clinical outcomes of prenatally detected hydronephrosis.Methods: In a period of 13 years 148 infants were referred with fetal hydronephrosis. The initial evaluation, after prophylaxis, included ultrasound and voiding cystography. Sequential evaluation was determined by initial findings.Results: Postnatal predominant diagnosis were pelviureteric junction obstruction (24%) and hydronephrosis without obstruction (18%). Follow up median was 38.7 months. Renal function deteriorated in 13 (8.8%) children and 11 (7.4%) died during follow up. Bad prognosis was associated with urethral obstruction.Conclusions: Fetal hydronephrosis is a clue of urinary tract anomalies. Urinary tract infections and delay in postnatal diagnosis must be prevented in children with this uropathy.

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Urinary tract dilatation in utero: classification and clinical applications.

Cited by 267 publications

References 0 publications

Mild Fetal Renal Pelvis Dilatation—Much Ado About Nothing?

Mild Fetal Renal Pelvis Dilatation—Much Ado About Nothing?

Ultrasonographic Evaluation of Foetal Hydronephrosis

Fetal hydronephrosis: postnatal management and follow up

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