Prognostic significance of antenatally detected fetal pyelectasis.
In order to evaluate the prognostic significance of ultrasonographically detected fetal pyelectasis, a retrospective review was performed of patients evaluated for fetal pyelectasis over a 24-month period. From 84 patients a total of 98 fetal kidneys with pyelectasis were identified. Fetal pyelectasis was more common in the left kidney and in males. Postpartum evaluation revealed 48 (57.1%) neonates with hydronephrosis. Among these, mean (SD; range) values of antenatal fetal pyelectasis were 17.0 mm (8.4; 5-26) before 33 weeks and 16.9 mm (8.5; 5-34) after 33 weeks in the left kidney and 15.4 mm (3.3; 10-24) and 17.1 mm (5.1; 5-36), respectively, in the right kidney. Thirteen infants (15.4%) with hydronephrosis required surgical pyeloplasties (mean age 6 months; range 3-18 months). It was found, from a receiver-operating characteristic curve, that fetal pyelectasis of 8 mm was 91% sensitive and 72% specific in predicting subsequent hydronephrosis. Use of a threshold of 5 mm yielded a sensitivity of 100% and a specificity of 24%. On the basis of these findings, we recommend that women with ultrasonographically detected antenatal fetal pyelectasis of > or = 5 mm at any gestational age have follow-up ultrasound examinations and detailed postnatal evaluation.
Ouzounian
J G
JG
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
Castro
M A
MA
Fresquez
M
M
al-Sulyman
O M
OM
Kovacs
B W
BW
D004108:Dilatation, Pathologic / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D007682:Kidney Pelvis / Q000000981:diagnostic imaging* / Q000196:embryology; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal