Aviram R, Pomeranz A, Sharony R, Beyth Y, Rathaus V, Tepper R
Ultrasound Unit, Sapir Medical Center, Kfar Saba, Israel.
Ultrasound Obstet Gynecol. 2000 Jul;16(1):60-2. doi: 10.1046/j.1469-0705.2000.00164.x.
To determine the effects of the changes in fetal renal pelvis dilatation on post-natal diagnosis and outcome.
Prenatal sonographic fetal renal anteroposterior diameters of > or = 4 mm in the second trimester, which persisted to > or = 7 mm in the third trimester, were the inclusion criteria. Fifty-six fetuses and 73 renal units with normal karotypes and a solitary sonographic finding of renal pyelectasis, which met the inclusion criteria, were followed, post-natally, until the age of 30 months. The neonates were categorized into three groups, according to their final diagnosis: No hydronephrosis, pelvi-ureteric junction obstruction and hydronephrosis from other causes. The neonates were also categorized according to their outcome: no treatment, follow-up only and surgical treatment.
In 17 neonates (30.4%), and 19 renal units, the diagnosis of hydronephrosis was excluded post-natally. In 39 neonates (69.6%), and 54 renal units, an urinary tract pathology was confirmed. The dynamics of pyelectasis in the second and third trimesters of pregnancy differed significantly among the neonates when categorized according to the final diagnosis (P < 0.05), or according to outcome (P < 0.05).
It is possible to predict, and distinguish between, long-term conservative and surgical treatments of renal pelvis dilatation in the third trimester of pregnancy.
确定胎儿肾盂扩张变化对出生后诊断及预后的影响。
纳入标准为孕中期产前超声检查胎儿肾盂前后径≥4 mm且在孕晚期持续≥7 mm。对56例胎儿及73个肾单位进行随访，这些胎儿核型正常，超声检查仅发现肾盂积水，符合纳入标准，随访至出生后30个月。根据最终诊断将新生儿分为三组：无肾盂积水、肾盂输尿管连接部梗阻及其他原因导致的肾盂积水。根据预后情况也将新生儿分为三类：无需治疗、仅需随访及需手术治疗。
17例新生儿（30.4%）及19个肾单位在出生后排除了肾盂积水诊断。39例新生儿（69.6%）及54个肾单位确诊存在泌尿系统病变。根据最终诊断（P<0.05）或预后情况（P<0.05）对新生儿进行分类时，妊娠中期和晚期肾盂积水的动态变化存在显著差异。
在妊娠晚期有可能预测并区分肾盂扩张的长期保守治疗和手术治疗。
