de Grauw Anne M, den Dekker Herman T, de Mol Amerik C, Rombout-de Weerd Sabina
a Department of Pediatrics , Albert Schweitzer Hospital Dordrecht , The Netherlands .
b Department of Pediatrics , Leiden University Medical Centre Leiden , The Netherlands .
J Matern Fetal Neonatal Med. 2016;29(2):237-41. doi: 10.3109/14767058.2014.996125. Epub 2014 Dec 26.
Antenatal hydronephrosis (ANH) is characteristic for congenital obstructive abnormalities of the urinary tract (COAUT). COAUT is the most common cause of urinary tract infections (UTI's) in newborns. The prognosis of mild to moderate ANH is unclear. The aim of this study was to determine the diagnostic value of antenatal ultrasound screening for ANH in order to inform patients correctly.
A retrospective cohort study over the period 2009-2011, evaluating all structural ultrasounds and proven cases of ANH. Also, evaluation of all patients diagnosed with UTIs caused by COAUT in the same period.
About 7003 children underwent antenatal screening. Of them, 0.7% (n = 47) were diagnosed with ANH. In the same period, 257 children without ANH had a proven UTI. Of them, 4.3% (n = 11) were diagnosed with COAUT, which was not found during antenatal screening. The predictive value of the antenatal ultrasound was higher in the third trimester than the second trimester (sensitivity 0.97 versus 0.62, respectively).
Antenatal ultrasound screening is a reliable method in diagnosing ANH. Third trimester scanning is more specific for diagnosing ANH than second trimester scanning. Our findings allow collaborating gynecologists and pediatricians to inform patients more accurately in the future after the antenatal detection of COAUT.
产前肾积水（ANH）是先天性尿路梗阻性异常（COAUT）的特征。COAUT是新生儿尿路感染（UTI）的最常见原因。轻度至中度ANH的预后尚不清楚。本研究的目的是确定产前超声筛查ANH的诊断价值，以便正确告知患者。
一项对2009年至2011年期间进行的回顾性队列研究，评估所有结构性超声检查及确诊的ANH病例。同时，评估同期所有诊断为由COAUT引起的UTI的患者。
约7003名儿童接受了产前筛查。其中，0.7%（n = 47）被诊断为ANH。同期，257名无ANH的儿童确诊患有UTI。其中，4.3%（n = 11）被诊断为COAUT，产前筛查未发现。产前超声在孕晚期的预测价值高于孕中期（敏感性分别为0.97和0.62）。
产前超声筛查是诊断ANH的可靠方法。孕晚期扫描比孕中期扫描对诊断ANH更具特异性。我们的研究结果使合作的妇科医生和儿科医生能够在产前检测到COAUT后，未来更准确地告知患者。
