Lam B C, Wong S N, Yeung C Y, Tang M H, Ghosh A
Department of Paediatrics, University of Hong Kong.
Am J Perinatol. 1993 Jul;10(4):263-8. doi: 10.1055/s-2007-994736.
Between January 1987 and December 1990, 60 fetuses were found to have renal abnormalities on antenatal ultrasonography. Six fetuses were aborted because of major renal abnormalities with or without associated chromosomal aberrations. Twelve babies with major renal abnormalities died in the immediate neonatal period. Forty-two babies were studied after birth and followed up. Babies who were found to have mild dilation of the renal pelvis of 6 to 10 mm during fetal life revealed either normal renal findings in the postnatal period or complete resolution of the abnormalities within the first year. Significant pelvic dilation of more than 10 mm occurred in 32 babies. A significant proportion (34%) had transitional hydronephrosis that resolved spontaneously during the follow-up period (mean, 2 1/2 years; range, 1 1/2 to 4 1/2 years). Extrarenal pelvis, another benign condition, accounted for 15.6%. Most babies with pelviureteral junction obstruction (15%) and vesicoureteral junction obstruction (6.2%) required early neonatal surgery. The technetium-99m diethylenetriamine renal scan with the diuretic renogram half-time was found to be a very useful tool to distinguish between obstructive and nonobstructive hydronephrosis. With early diagnosis and intervention, the prognosis for many of these renal abnormalities is much more favorable and such information is invaluable for antenatal counseling.
1987年1月至1990年12月期间，60例胎儿在产前超声检查中被发现有肾脏异常。6例胎儿因严重肾脏异常伴或不伴有相关染色体畸变而流产。12例有严重肾脏异常的婴儿在新生儿早期死亡。42例婴儿出生后接受了研究并进行了随访。在胎儿期发现肾盂轻度扩张6至10毫米的婴儿，在出生后肾脏检查结果正常或在第一年内异常完全消失。32例婴儿出现肾盂显著扩张超过10毫米。相当一部分（34%）有暂时性肾积水，在随访期间（平均2.5年；范围1.5至4.5年）自行消退。肾外肾盂是另一种良性情况，占15.6%。大多数肾盂输尿管连接部梗阻（15%）和膀胱输尿管连接部梗阻（6.2%）的婴儿需要在新生儿早期进行手术。发现锝-99m二乙三胺肾扫描结合利尿肾图半衰期是区分梗阻性和非梗阻性肾积水的非常有用的工具。通过早期诊断和干预，许多这些肾脏异常的预后要乐观得多，此类信息对于产前咨询非常宝贵。
