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Prognostic significance of antenatally detected fetal pyelectasis
Author(s) -
Ouzounian J. G.,
Castro M. A.,
Fresquez M.,
AlSulyman O. M.,
Kovacs B. W.
Publication year - 1996
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.1996.07060424.x
Subject(s) - medicine , hydronephrosis , obstetrics , gestational age , fetus , obstetrics and gynaecology , gynecology , pregnancy , urinary system , biology , genetics
In order to evaluate the prognostic significance of ultra‐sonographically detected fetal pyelectasis, a retrospective review was performed of patients evaluated for fetal pyelectasis over a 24‐month period. From 84 patients a total of 98 fetal kidneys with pyelectasis were identified. Fetal pyelectasis was more common in the left kidney and in males. Postpartum evaluation revealed 48 (57.1%) neonates with hydronephrosis. Among these, mean (SD; range) values of antenatal fetal pyelectasis were 17.0 mm (8.4; 5–26) before 33 weeks and 16.9 mm (8.5; 5–34) after 33 weeks in the left kidney and 15.4 mm (3.3; 10–24) and 17.1 mm (5.1; 5–36), respectively, in the right kidney. Thirteen infants (15.4%) with hydronephrosis required surgical pyeloplasties (mean age 6 months; range 3–18 months). It was found, from a receiver‐operating characteristic curve, that fetal pyelectasis of 8 mm was 91% sensitive and 72% specific in predicting subsequent hydronephrosis. Use of a threshold of 5 mm yielded a sensitivity of 100% and a specificity of 24%. On the basis of these findings, we recommend that women with ultrasonographically detected antenatal fetal pyelectasis of ≥ 5 mm at any gestational age have follow‐up ultra‐sound examinations and detailed postnatal evaluation. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology