[Therapy and prognosis of children with prenatally diagnosed urinary tract abnormalities].
Urinary tract malformations are recognized already prenatally to an increasing extent, but the indications for, and the time of surgical intervention are still a matter of debate. The present study is an analysis of the data collected over an 80-month period of 76 patients whose urinary tract malformation was suspected prenatally and confirmed after birth. Patients with lethal malformations whose disease led to abortion or intrauterine death were excluded. Ureteropelvic junction obstruction was present in 47% of the patients and obstructive uropathy accounted for 67% of all malformations. In contrast, vesicoureteric reflux was found only in eight patients. Thirty seven infants (49%) required surgical intervention and 61% of all operations were performed during the first month of life. 57% of these early interventions were temporary diversions. The indication for surgical treatment was based on sonographic and radiological assessment of the malformation and on the results of functional assessment. In many instances surgery was delayed until indicated on the basis of the findings of the follow-up studies. All reconstruction operations were successful. Prenatal diagnosis benefitted most children, especially those with the most severe malformations. No patient died as a result of the renal condition and the prognosis is grave in only one child, who is likely to go into terminal renal failure in childhood.
Ring
E
E
Universitäts-Kinderklinik, Graz.
Petritsch
P
P
Riccabona
M
M
Zobel
G
G
Vilits
P
P
D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D007690:Polycystic Kidney Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D011296:Prenatal Diagnosis; D011379:Prognosis; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000151:congenital / Q000601:surgery; D014547:Urinary Diversion; D014551:Urinary Tract / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000601:surgery
Therapie und Prognose von Kindern mit pränatal diagnostizierten Harnwegsfehlbildungen.