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Is screening for vesicoureteral reflux mandatory in infants with antenatal renal pelvis dilatation?
Author(s) -
LIDEFELT KARLJOHAN,
EK SVERKER,
MIHOCSA LAZLO
Publication year - 2006
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1080/08035250600764826
Subject(s) - medicine , vesicoureteral reflux , renal pelvis , cystourethrography , renal dysplasia , reflux , pregnancy , pelvis , urology , obstetrics , ureter , urinary system , surgery , disease , biology , genetics
Abstract Aim : To determine whether postnatal ultrasound (US) can guide the use of voiding cystourethrography (VCUG) in infants with antenatally detected renal pelvis dilatation (ARPD). Methods : 14000 pregnant women consecutively underwent routine US examination during the second trimester. US examinations later in pregnancy were performed as follow‐up of previous anomalies or on obstetrical indications. One hundred and six fetuses with ARPD ≥5 mm were identified. Two postnatal US examinations were performed in the newborns: on the 5th to 7th day and during the 3rd week of life. The findings were considered normal when renal pelvis dilatation (RPD) was ≤7 mm on both US examinations, and no calyceal or ureteric dilatation or signs of renal dysplasia or other anomalies were present. VCUG was done 6 to 8 wk after birth. Results : In 53 of 103 analysable infants, the postnatal ultrasonographic findings were normal. The VCUG was abnormal in three of these 53 infants, all with vesicoureteral reflux (VUR) grade I. Of 50 infants who had abnormal US examinations, six had VUR, four of which were grade IV and V reflux. Conclusion : In infants with ARPD who undergo two postnatal US examinations with RPD ≤7 mm and have no other abnormalities, VCUG is unnecessary.