Kari Jameela Abdulaziz, Habiballah Saddiq, Alsaedi Saad A, Alsaggaf Hussain, Al-dabbagh Amal, AbulHamail Adila, Marzouki Adel, Eldeek Basem
Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
Ann Saudi Med. 2013 May-Jun;33(3):260-4. doi: 10.5144/0256-4947.2013.260.
Antenatally detected urinary tract abnormalities (ADUTA) are increasingly recognized. Our aims were to determine the incidence and outcomes of antenatally diagnosed congenital hydronephrosis in a large cohort.
We recorded the number of total deliveries over 4 years at King Abdulaziz University Hospital (KAUH) between January 2008 and December 2011 from the number of nursery and neonatal intensive care unit (NICU) admissions.
We reviewed the records of 18 853 deliveries between January 2008 and December 2011 at KAUH, Saudi Arabia. ADUTA were recorded, and their postnatal medical records were reviewed for demographic and radiological data.
ADUTA were diagnosed in 327 fetuses (1.7%). The commonest pathology was congenital hydronephrosis (n=313, 95.7%). Cystic renal anomalies were reported in 4 babies (1.2%), and 10 children (3.1%) were reported to have other renal anomalies, including duplex kidneys or a single kidney. A total of 240 babies with congenital hydronephrosis were followed up. Hydronephrosis resolved in 99 children (41.2%) within 2 months of birth. A total of 29 subjects had underlying renal anomalies (12.1%), including vesicoureteral reflux (n=12, 5%), pelvi-ureteric junction obstruction (n=14, 5.8%), and posterior urethral valve (n=3, 1.3%). The best predictor for nonresolving congenital hydronephrosis and underlying anatomical abnormalities was the anteroposterior diameter on the first postnatal scan. A cut-off point of 5 mm was found to be 83% sensitive in predicting nonresolving hydronephrosis, while 7 mm was 88% sensitive and 10 mm was 94% sensitive.
Congenital hydronephrosis is the commonest ADUTA. A large percentage resolved within 2 months of birth, but underlying anatomical abnormalities were found in 12.1%. All babies with antenatally detected hydronephrosis should be examined by ultrasound postnatally but further radiological investigations should only be performed for persistent significant AP dilatation >=10 mm.
产前检测出的尿路异常（ADUTA）越来越受到关注。我们的目的是确定一大群队列中产前诊断的先天性肾积水的发病率和结局。
我们记录了2008年1月至2011年12月期间在阿卜杜勒阿齐兹国王大学医院（KAUH）4年的分娩总数，数据来源于新生儿重症监护病房（NICU）的入院人数。
我们回顾了沙特阿拉伯KAUH医院2008年1月至2011年12月期间18853例分娩的记录。记录ADUTA情况，并查阅其产后病历以获取人口统计学和放射学数据。
327例胎儿（1.7%）被诊断为ADUTA。最常见的病理情况是先天性肾积水（n = 313，95.7%）。4例婴儿（1.2%）报告有肾囊性异常，10例儿童（3.1%）报告有其他肾脏异常，包括重复肾或单肾。共对240例先天性肾积水婴儿进行了随访。99例儿童（41.2%）在出生后2个月内肾积水消退。共有29例受试者存在潜在肾脏异常（12.1%），包括膀胱输尿管反流（n = 12，5%）、肾盂输尿管连接部梗阻（n = 14，5.8%）和后尿道瓣膜（n = 3，1.3%）。出生后首次扫描时的前后径是先天性肾积水不消退及潜在解剖学异常的最佳预测指标。发现5mm的截断点预测肾积水不消退的敏感性为83%，7mm时敏感性为88%，10mm时敏感性为94%。
先天性肾积水是最常见的ADUTA。很大比例在出生后2个月内消退，但12.1%存在潜在解剖学异常。所有产前检测出肾积水的婴儿出生后均应接受超声检查，但仅对持续存在的前后径显著扩张≥10mm的情况进行进一步的放射学检查。
