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WS01‐07Borderline urinary tract malformations
Author(s) -
D'ottavio G.,
Paduano L.,
Rustico M. A.,
Meir Y. J.,
Lenardon P.,
Rosadini A.,
Mandruzzato G. P.
Publication year - 2000
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.1469-0705.2000.00009-1-7.x
Subject(s) - medicine , urinary system , ectopic kidney , renal agenesis , asymptomatic , nephrectomy , renal pelvis , renal function , obstetrics , prenatal diagnosis , kidney , pregnancy , fetus , surgery , biology , genetics
Background Ultrasonography is an effective diagnostic tool for identifying fetal urinary tract anomalies (UTA). Serious obstructive or dysgenetic abnormalities are often clearly detected and their implications well known. Less clear is the meaning of borderline (asymptomatic at birth) UTA, including: mild pyelectasis (MP), unilateral renal agenesis (URA), unilateral multicystic kidney (UMK) and ectopic kidney (EK). Method We determined the outcome of pregnancies and long‐term renal function in 120 cases of prenatally detected borderline UTA. A prospective protocol was proposed to the parents which comprised ultrasound evaluation every 3 months until the age of 24 months, and renal function assessment in case of suspected worsening of prenatal findings. Results A total of 120 fetuses had a borderline UTA (MP n = 58, URA n = 14, UMK n = 32, EK n = 16). Eighteen of them showed some postnatal complication including: associated anomalies (3 cases), need for surgical intervention (6 cases), vesico‐ureteral reflux (VUR, 5 cases) and repeated infection (4 cases). Conclusions Fetal pyelectasis, rarely requires neonatal intervention if the diameter of pelvis is included between 5 and 10 mm in the second trimester. Nevertheless, the risk of associated chromosome abnormalities should be ruled out if other risk factors are present. Unilateral multicystic kidney carries a high risk of nephrectomy and contralateral VUR, whereas unilateral agenesis or ectopic kidneys seem to carry limited, if any, negative implications, with the exception of possible undetected, associated anomalies.