Scott J E, Renwick M
Department of Surgery, University of Newcastle upon Tyne.
Arch Dis Child. 1993 Jan;68(1 Spec No):22-6. doi: 10.1136/adc.68.1_spec_no.22.
From 1 January 1985 to 31 December 1990, the Northern Region Fetal Abnormality Survey received 736 notifications of fetuses with suspected urological abnormalities; a prevalence of three per 1000 births. There was a male:female ratio of 2:1, the ratio was higher in obstructive than in intrinsic renal parenchymal lesions. Overall diagnostic sensitivity was 68.9% and positive predictive value 50.8%. Hydronephrosis was the most frequent antenatal diagnosis (421 cases, 57.2%): 233 (55.3%) of these were found to be normal postnatally. There were 52 other false positive diagnoses. Of 113 babies with confirmed hydronephrosis antenatal diagnosis was correct in 97, sensitivity 85.8%, specificity 48.1%; 1.8% of these had chromosome defects. In 33 cases of bilateral renal agenesis antenatal diagnosis was correct or potentially correct in 24, sensitivity 72.7%, specificity 98.9%. Only six of 26 babies with posterior urethral valves were suspected, sensitivity 23%, specificity 98.7%. Mortality rate in 91 babies with unsuspected abnormalities was 39.6%: overall mortality was 24.2%. Unsuspected abnormalities occurred more frequently when mothers were not scanned after the 16th week of pregnancy.
1985年1月1日至1990年12月31日，北部地区胎儿异常调查收到736例疑似泌尿系统异常胎儿的通报；每1000例出生中的患病率为3例。男女比例为2:1，梗阻性病变中的比例高于肾实质内在性病变。总体诊断敏感性为68.9%，阳性预测值为50.8%。肾积水是最常见的产前诊断（421例，57.2%）：其中233例（55.3%）出生后被发现正常。还有52例假阳性诊断。在113例确诊肾积水的婴儿中，产前诊断正确的有97例，敏感性为85.8%，特异性为48.1%；其中1.8%有染色体缺陷。在33例双侧肾缺如病例中，产前诊断正确或可能正确的有24例，敏感性为72.7%，特异性为98.9%。26例后尿道瓣膜婴儿中仅6例被怀疑，敏感性为23%，特异性为98.7%。91例未被怀疑有异常的婴儿的死亡率为39.6%：总体死亡率为24.2%。当母亲在怀孕16周后未进行扫描时，未被怀疑的异常情况更频繁地发生。
