[Prenatal and postnatal ultrasonic screening in the early diagnosis and treatment of congenital developmental defects of the kidneys and urinary tract].
The author presents a group of 97 children with congenital developmental malformations of the kidneys and urinary pathways diagnosed by ultrasound screening in 1990-1994. In 15 children the diagnosis was established prenatally, in 67 children by early postnatal screening and in 15 children during examination of the hip joints. The majority was formed by obstructive uropathies. In more than 50% of these children advanced uropathies were involved with a renal function reduced to 40% and less. A total of 129 operations were performed, incl. 94 (72.8%) reconstruction operations and 11 temporary derivation operations (9.1%). Nephrectomies were performed only in 9 children because of multicystic dysplasia, and in 9 children with duplicated upper urinary pathways resection of the kidneys was performed on account of dysplasia and advanced atrophy of the renal parenchyma. 80% of all operations was performed in infants under 6 months, 21.7% of the operations at the age under 1 month. The best results were achieved in children after plastic operations made before the age of 1 month. The highest yield was obtained by early postnatal screening. It should therefore become an integral part of neonatal examinations. Prenatal ultrasonographic screening is indicated in particular in pregnant women with a family-history of anomalies of the urinary pathways.
Utíkalová
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Urologická klinika LF UP, Olomouc.
D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014517:Ureteral Obstruction / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery; D014551:Urinary Tract / Q000002:abnormalities* / Q000000981:diagnostic imaging