|ECR 2018 / C-1990|
|Prenatal ultrasound diagnosis of urinary tract anomalies and postnatal outcome|
A total of 54 urinary tract anomalies were reviewed. The mean maternal age at prenatal diagnosis was 31 years old and the median gestational age was 27 weeks. More than two thirds of the fetus were male (68.5%).
Urinary tract dilatation was the most frequent diagnosis present in 51 patients (94.4%). Severe hydronephrosis, with anterior-posterior renal pelvis diameter above 10 mm, was diagnosed in 35.3% of the cases. Multicystic dysplastic kidney was the most frequent detected structural malformation of the urinary tract, present in 5 patients (9.2%). Other findings consisted of duplex system (three cases), kidney agenesia (one case), ureterocele (one case) and congenital megaureter (one case).
Prenatal diagnoses corresponded to the postnatal ones in 85.2% of cases. This is a high level of correspondence and is similar to previous reports5,6. Diagnoses that did not correspond consisted of urinary tract dilatations that normalized after birth (13%), following natural disease history. The other diagnosis that did not match was a prenatal diagnosis of mild ANH that was found to be a duplex system. However, when one of the pelvis is not dilated, this condition cannot be identified in antenatal US.
There was a significant association between prenatal severe hydronephrosis and the need for surgery (p-value < 0.01). This could be explained by the higher grade of obstruction and risk of renal function impairment. Nonetheless, there are several reports of ANH that had spontaneous resolution. Therefore, close US follow-up after birth is essential in these cases.
Limitations of this study were the lack of data on false-negative cases or postnatal diagnosis cases that were not identified in the prenatal screening.
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