Fugelseth D, Lindemann R, Sande H A, Refsum S, Nordshus T
Department of Pediatrics, Ullevål Hospital, Oslo, Norway.
Acta Obstet Gynecol Scand. 1994 Apr;73(4):290-3. doi: 10.3109/00016349409015765.
To determine when fetal urinary tract anomalies were detected by ultrasound screening during pregnancy and to discuss the possible consequences if only one early ultrasound examination is performed.
A retrospective study of 47 cases where fetal urinary tract malformations were diagnosed in a two-stage screening program (17th and 32nd week of gestation) covering 22,310 women over ten years, 1982-91.
Ullevål University Hospital in Oslo which serves as a referral center for obstetric and neonatal diseases.
Urinary tract anomalies were diagnosed in 0.18% of the pregnancies. Of these, 61.7% were found at the second routine ultrasound screening. The most difficult differential diagnoses were those of hydronephrosis without megaureter and a multicystic kidney. Hydronephrosis was found in 51% and a multicystic kidney in 21% of the cases. The tentative prenatal diagnoses were confirmed postnatally in 83% of the cases. Six of the fetuses had anomalies regarded as incompatible with postnatal life. These pregnancies were terminated, and the diagnoses verified by autopsy. Two other infants died perinatally, one of them as a result of the urinary tract anomalies.
If only one ultrasound scanning had been performed in the 17th week, approximately two-thirds of the cases would not have been detected. Early intervention and follow-up after delivery would only have been performed if the infants had developed symptoms or complications related to the urinary tract anomalies.
确定孕期超声筛查中何时能检测到胎儿泌尿系统异常，并探讨仅进行一次早期超声检查可能产生的后果。
对1982年至1991年十年间在两阶段筛查计划（妊娠第17周和第32周）中诊断出胎儿泌尿系统畸形的47例病例进行回顾性研究，该筛查计划覆盖了22310名女性。
奥斯陆的于勒沃尔大学医院，它是产科和新生儿疾病的转诊中心。
在0.18%的妊娠中诊断出泌尿系统异常。其中，61.7%是在第二次常规超声筛查时发现的。最难鉴别的诊断是无巨输尿管的肾积水和多囊肾。在51%的病例中发现了肾积水，21%的病例中发现了多囊肾。83%的病例产前初步诊断在产后得到证实。6例胎儿的异常被认为与出生后生活不相容。这些妊娠被终止，诊断通过尸检得到证实。另外两名婴儿在围产期死亡，其中一名死于泌尿系统异常。
如果仅在第17周进行一次超声扫描，大约三分之二的病例将无法被检测到。只有当婴儿出现与泌尿系统异常相关的症状或并发症时，才会在出生后进行早期干预和随访。
