Özel Ayşegül, Alıcı Davutoğlu Ebru, Erenel Hakan, Karslı Mehmet Fatih, Korkmaz Sevim Özge, Madazlı Rıza
Department of Obstetrics and Gynecology, Perinatology Unit, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
J Turk Ger Gynecol Assoc. 2018 Nov 15;19(4):206-209. doi: 10.4274/jtgga.2017.0132. Epub 2018 Apr 4.
With the widespread use of ultrasonography for fetal screening, the detection and management of congenital urinary tract abnormalities has become crucial. In this study, we aimed to describe the clinical approaches in patients with prenatally detected urinary tract abnormalities.
This study is a retrospective, single-center study performed at a perinatology unit of a university hospital, between 2010 and 2016. The outcomes of 124 patients who were prenatally diagnosed as having urinary tract abnormalities are reported. Variables included in the analysis were fetal sex, birth week and weight, persistency, and necessity surgery after birth for renal pelvic dilatation. Low-risk renal pelvic dilatation was determined as an anterior-posterior (AP) diameter of 4-7 mm at 16-28 weeks, 7-10 mm after 28 weeks, whereas high-risk dilatation was defined as AP measurements of ≥7 mm at 16-28 weeks, ≥10 mm after 28 weeks, respectively.
The majority of patients consisted of male fetuses with bilateral pelviectasis (62.9%, 20.2%, respectively). The mean age was 28.8±6.4 years. The mean gestational age at birth was 34.2±7.8 weeks. The mean birth weight was 2593±1253.3 g. The need for surgery was greater in high-risk patients than in low-risk patients (58.3% vs. 8.7%) (p<0.002).
Patients with high-risk antenatal renal pelvic dilatation require surgical treatment after delivery. Close prenatal and postnatal follow-up is mandatory in specialized centers. Perinatologists, neonatologists, pediatricians and pediatric nephrologists, and radiologists should treat these children with a multidisciplinary approach.
随着超声检查在胎儿筛查中的广泛应用，先天性泌尿系统异常的检测和管理变得至关重要。在本研究中，我们旨在描述产前检测出泌尿系统异常患者的临床处理方法。
本研究是一项回顾性单中心研究，于2010年至2016年在一所大学医院的围产医学科进行。报告了124例产前诊断为泌尿系统异常患者的结局。分析中纳入的变量包括胎儿性别、出生孕周和体重、持续性以及出生后因肾盂扩张进行手术的必要性。低风险肾盂扩张定义为16 - 28周时前后径为4 - 7毫米，28周后为7 - 10毫米，而高风险扩张分别定义为16 - 28周时前后径≥7毫米，28周后≥10毫米。
大多数患者为双侧肾盂扩张的男性胎儿（分别为62.9%、20.2%）。平均年龄为28.8±6.4岁。出生时的平均孕周为34.2±7.8周。平均出生体重为2593±1253.3克。高风险患者比低风险患者更需要手术（58.3%对8.7%）（p<0.002）。
产前高风险肾盂扩张患者产后需要手术治疗。在专业中心进行密切的产前和产后随访是必要的。围产医学专家、新生儿科医生、儿科医生、儿科肾病学家和放射科医生应以多学科方法治疗这些儿童。
