Prenatally diagnosed reflux: a follow-up study.
This report analyses the characteristics and outcome of 25 infants with vesicoureteric reflux detected prenatally on the basis of dilatation of the fetal urinary tract. Sixteen infants had bilateral reflux--a total of 41 refluxing units. The high proportion of males (84%) contrasts with clinically presenting reflux, which is dominated by females. Prenatally diagnosed reflux is generally of a higher grade--usually grade IV. Eight children (32%) had coexistent congenital abnormalities. Chemoprophylaxis was completely effective in 17 children (68%), who remained infection-free; 3 children (12%) had a single urinary infection and were managed conservatively whilst 5 (20%) experienced 2 or more infections and required reimplantation or vesicostomy. Spontaneous cessation of reflux was observed in 6 (35%) of 17 refluxing ureters reassessed after a mean interval of 2.1 years. The significance of isotope findings was sometimes difficult to assess but results in 30 refluxing units support the concept that focal renal scarring is usually a consequence of infected reflux in postnatal life.
Gordon
A C
AC
Department of Paediatric Surgery, General Infirmary, Leeds.
Thomas
D F
DF
Arthur
R J
RJ
Irving
H C
HC
Smith
S E
SE
D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012737:Sex Factors; D014295:Trimethoprim / Q000627:therapeutic use; D014463:Ultrasonography; D014551:Urinary Tract / Q000002:abnormalities; D014552:Urinary Tract Infections / Q000150:complications; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D014295:Trimethoprim