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Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: A systematic review and meta‐analysis
Author(s) -
Bascietto Francesca,
Khalil Asma,
Rizzo Giuseppe,
Makatsariya Alexander,
Buca Danilo,
Silvi Claudia,
Ucci Matteo,
Liberati Marco,
Familiari Alessandra,
D'Antonio Francesco
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5622
Subject(s) - medicine , prenatal diagnosis , megaureter , ureterocele , fetus , obstetrics , vesicoureteral reflux , urinary system , multicystic dysplastic kidney , ultrasound , pregnancy , pediatrics , radiology , pathology , reflux , disease , genetics , biology
Objectives To perform a systematic review of studies reporting the outcome of fetuses with a prenatal diagnosis of isolated duplex collecting system (DCS). Methods Inclusion criteria were studies reporting the outcome of fetuses with a prenatal diagnosis of isolated DCS, defined as DCS not associated with other major structural anomalies at the time of diagnosis. The outcomes observed were: imaging features of DCS on prenatal ultrasound, associated anomalies detected exclusively at prenatal follow‐up ultrasound and at birth, abnormal karyotype, symptoms at birth (including vesicoureteral reflux [VUR] and urinary tract infections [UTI]), need for and type of surgical approach, complications after surgery, and accuracy of prenatal ultrasound in correctly identifying this anomaly. Results Eleven studies (284 fetuses with a prenatal diagnosis of DCS) were included. On ultrasound, DCS was associated with ureterocele in 70.7% and with megaureter in 36.6% of cases. Worsening of pelvic/ureteric dilatation was reported to occur in 41.3% of fetuses. At birth, 4.3% of fetuses affected by DCS showed associated renal anomalies. After birth, VUR and UTI presented in 51.3% and 21.7% of children respectively, while 33.6% required surgery. Prenatal diagnosis of DCS was confirmed in 90.9% of included cases. Conclusion DCS diagnosed prenatally is associated with a generally good outcome. Prenatal ultrasound has a good diagnostic accuracy, while detailed postnatal assessment is required in order to identify associated renal anomalies.