The association between fetal pyelectasis on second trimester ultrasound scan and aneuploidy among 25,586 low risk unselected women.
OBJECTIVE
To determine the association of fetal pyelectasis FP found at the time of second trimester detailed ultrasound scan with aneuploidy in an unselected low-risk population.


METHODS
Retrospective study of ultrasonographic reports, films and hospital notes over an eight-year period from 1991 to 1998.


METHODS
District general hospital obstetric department with 3500 deliveries annually serving a low-risk cosmopolitan population.


METHODS
The prevalence of aneuploidy in cases of fetal pyelectasis.


METHODS
The obstetric ultrasound reports and films of 29,591 cases were reviewed to identify those with FP at their detailed anomaly scan between 18 and 24-weeks gestation. The study sample included women whose scan showed the fetal renal pelvis of either kidney to be five millimetres or more in the anteroposterior diameter. Demographic data and other ultrasonographic abnormalities were noted. The genotype and phenotype of the babies were traced from a combination of cytogenetic reports and paediatric notes.


RESULTS
There were 320 cases of FP among the 25,586 low-risk study population available in the studied gestational period (18-24 weeks) giving a prevalence of 1.25 percent. Of these, 301 cases of FP were found in isolation and 19 were found in association with another ultrasonographic marker. None of the 315 cases delivering at the Northwick Park & St. Mark's Hospital had aneuploidy. Pyelectasis was more likely to be bilateral (57%), and more in male fetuses (72%). The mean diameter for the pyelectasis at diagnosis was 6.5 mm (1.4 SD) ranging between 5 and 15 mm. One hundred and thirty seven cases (43%) resulted in spontaneous resolution.


CONCLUSIONS
The prevalence of FP at the anomaly scan in an unselected low-risk population is not high (1.25%). Our data suggest that the risk of aneuploidy associated with isolated FP in a low-risk, unselected population is so small that it should not be an indication for invasive prenatal karyotyping.
Havutcu
A E
AE
Department of Obstetrics & Gynaecology Department, Northwick Park & St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ.
Nikolopoulos
G
G
Adinkra
P
P
Lamont
R F
RF
D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000235:genetics; D004739:England / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D007682:Kidney Pelvis / Q000002:abnormalities / Q000000981:diagnostic imaging*; D008297:Male; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012737:Sex Factors; D016216:Ultrasonography, Prenatal