Kumar Manisha, Gupta Usha, Thakur Seema, Aggrawal Shilpi, Meena Jyoti, Sharma Sumedha, Trivedi Shubha S
Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.
Indian J Hum Genet. 2012 Jan;18(1):75-82. doi: 10.4103/0971-6866.96656.
To determine the prognosis of antenatally detected renal anomalies by sonographic evaluation.
This was a follow-up study of all antenatally detected renal anomalies from January 2008 to Dec 2009 referred to fetal medicine clinic. Prenatal evaluation was done and cases were divided into four groups depending upon their prenatal sonographic findings. Post natal follow-up was done up to one year in cases of live babies. Autopsy was carried out in still born fetus after consent.
The renal anomaly was detected in 55 cases, which were fully followed. The prognosis was said to be poor for group I cases with gross extra renal anomaly along with the renal anomaly, and for group II in which there was organic renal pathology with loss of renal function suggested by non-visualization of bladder and almost absent liquor. Prognosis was guarded and depended upon the gestational age of presentation in group III, which had obstructive uropathy; prognosis was good in group IV cases, which were mild, unilateral or which presented late.
Prenatal sonographic evaluation gives reasonably accurate picture of the prognosis and can be very helpful in counseling the parents regarding prognosis and help in deciding the timing and route of delivery.
通过超声评估确定产前检测出的肾脏异常的预后情况。
这是一项对2008年1月至2009年12月转诊至胎儿医学门诊的所有产前检测出的肾脏异常病例的随访研究。进行了产前评估,并根据产前超声检查结果将病例分为四组。对存活婴儿进行了长达一年的产后随访。经同意后,对死产胎儿进行了尸检。
共检测出55例肾脏异常病例,并对其进行了全面随访。对于第一组伴有严重肾外异常及肾脏异常的病例,以及第二组存在器质性肾脏病变且因膀胱未显示和羊水几乎缺失提示肾功能丧失的病例,预后被认为较差。对于第三组患有梗阻性尿路病的病例,预后情况谨慎,取决于就诊时的孕周;第四组病例为轻度、单侧或就诊较晚的病例,预后良好。
产前超声评估能对预后情况给出较为准确的描述,在向父母咨询预后情况以及帮助决定分娩时间和方式方面非常有帮助。