Department of Pediatric Surgery, CHU de La Réunion, Saint-Denis, La Reunion, France.
Department of Pediatric Surgery, CHU Pellegrin-Enfants, Bordeaux, France.
Prenat Diagn. 2017 Sep;37(9):931-934. doi: 10.1002/pd.5120. Epub 2017 Aug 6.
Prenatal management of male fetuses with suspected posterior urethral valves depends on reliable markers for postnatal long-term renal function. Whether ultrasound parameters, including the presence or absence of oligohydramnios, are reliable remains the subject of debate. We decided to evaluate the reliability of quantity of amniotic fluid to predict postnatal renal function using decision curve analysis (DCA), a method for evaluating the clinical utility of a diagnostic test.
We analyzed retrospectively 51 male fetuses born with prenatally suspected posterior urethral valves between 2009 and 2012. We studied the relationship between quantity of amniotic fluid on prenatal ultrasound and the nadir creatinine during the first year of life as a proxy of postnatal renal function using DCA.
Twelve fetuses presented with prenatal oligohydramnios. Thirty-one children had a normal nadir creatinine, of which one had prenatal oligohydramnios (3.2%). Thirteen had a nadir creatinine between 35 and 75 μmol/L, of which four had prenatal oligohydramnios (30.8%). Seven had a nadir creatinine >75 μmol/L, all of them had prenatal oligohydramnios.
In this retrospective study, DCA confirms the relationship between prenatal quantity of amniotic fluid volume and postnatal renal function. © 2017 John Wiley & Sons, Ltd.
男性胎儿疑似后尿道瓣膜的产前处理取决于可靠的出生后长期肾功能标志物。羊水过少等超声参数是否可靠仍存在争议。我们决定使用决策曲线分析（DCA）评估羊水数量预测出生后肾功能的可靠性，DCA 是一种评估诊断试验临床实用性的方法。
我们回顾性分析了 2009 年至 2012 年间出生的 51 例产前疑似后尿道瓣膜的男性胎儿。我们使用 DCA 研究了产前超声羊水数量与出生后第一年肌酐最低值之间的关系，以肌酐最低值作为出生后肾功能的替代指标。
12 例胎儿存在产前羊水过少。31 例儿童的肌酐最低值正常，其中 1 例有产前羊水过少（3.2%）。13 例肌酐最低值在 35 至 75μmol/L 之间，其中 4 例有产前羊水过少（30.8%）。7 例肌酐最低值>75μmol/L，均有产前羊水过少。
在这项回顾性研究中，DCA 证实了产前羊水数量与出生后肾功能之间的关系。©2017 约翰威立父子公司。
