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Management of Mild Fetal Pyelectasis
Author(s) -
Yamamura Yasuko,
Swartout Jessica P.,
Anderson Elisabeth A.,
Knapp Carla M.,
Ramin Kirk D.
Publication year - 2007
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2007.26.11.1539
Subject(s) - medicine , obstetrics , pregnancy , fetus , in utero , retrospective cohort study , surgery , genetics , biology
Objectives The purpose of this study was to compare 2 protocols for the antenatal management of isolated mild fetal pyelectasis and perform a cost analysis. Methods A retrospective analysis of unilateral and bilateral mild fetal pyelectasis followed at our institution from 2003 to 2006 was conducted. Fetuses with additional congenital anomalies or aneuploidy were excluded. χ 2 analysis was used, and P < .05 was considered significant. Results Two hundred forty‐four cases were identified, of which the majority were male (75.4% versus 24.6%). Eighty‐eight patients were reevaluated every 4 weeks (protocol 1). The remaining 156 patients were reevaluated once in the third trimester (protocol 2). The mean number of ultrasound examinations in protocol 1 was 3.24, at a cost of $1187, compared with protocol 2, at $798. Resolution occurred in 59%, stabilization in 29%, and progression in 12%. There were no cases of progression to severe pyelectasis or a need for in utero intervention in either group. Conclusions Mild fetal pyelectasis can be managed with 1 additional third‐trimester ultrasound examination without a compromise in patient care. Average cost savings were $389 per patient for protocol 2, suggesting a benefit from this protocol over protocol 1.