Becker Amy M
Department of Pediatrics, U.T. Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9063, USA.
Curr Opin Pediatr. 2009 Apr;21(2):207-13. doi: 10.1097/mop.0b013e32832772a8.
Antenatally detected renal abnormalities are frequently encountered. Recommended postnatal evaluation of these infants has evolved to minimize invasive testing while maximizing detection of significant abnormalities.
There is a low rate of detectable renal abnormalities in infants with a normal postnatal sonogram at 4-6 weeks of age. Routine prophylactic antibiotics are not indicated in infants with isolated antenatal hydronephrosis. Infants with a multicystic dysplastic kidney and a normal contralateral kidney on renal ultrasound do not require further evaluation. Parents of these children should be counseled on symptoms of urinary tract infections to allow prompt diagnosis.
All infants with abnormalities on antenatal sonogram should undergo postnatal evaluation with a sonogram after birth and at 4-6 weeks of age. Further evaluation can be safely limited when the postnatal sonogram is normal at 6 weeks of age.
产前检测出的肾脏异常情况较为常见。针对这些婴儿的推荐产后评估方法已经有所发展,旨在尽量减少侵入性检查,同时最大程度地检测出重大异常。
出生后4至6周超声检查正常的婴儿中,可检测到的肾脏异常发生率较低。孤立性产前肾积水的婴儿无需常规预防性使用抗生素。肾脏超声显示为多囊性发育不良肾且对侧肾脏正常的婴儿无需进一步评估。应向这些患儿的父母讲解尿路感染的症状,以便及时诊断。
所有产前超声检查有异常的婴儿出生后及出生4至6周时均应接受超声检查进行产后评估。若出生6周时产后超声检查正常,则可安全地限制进一步评估。