[Prenatal screening of kidney pelvis ectasia, frequently caused by vesico-ureteral reflux detected after birth. Analysis of a series of 159 cases in 4 years at a maternal-child unit].
To describe the pre- and post-natal management of vesico-ureteric reflux in a prospective study of babies presenting with vesico-ureteric reflux suspected from pre-natal ultrasonography in a tertiary paediatric center.


METHODS
Between 1997 and 2001, 35 children (25 boys and 10 girls) with were vesico-ureteric reflux followed for 12 to 36 months after the pre-natal detection of urinary tract anomalies. Ultrasound examination was realized at the 5th of life, retrograde cystography at the 15th if the renal pelvic dilatation measured at least 10 mm of diameter. In 11 the reflux was bilateral and 46 refluxing units were reviewed.


RESULTS
According to the international classification of, 7% vesico-ureteric reflux were grade I, 20.5% were grade II, 32% were grade III, 18% were grade IV, 22.5% were grade V. Fourteen patients (17 refluxing units) underwent ureteric-reimplantation. Four total and two partial nephrectomics were carried out in patients < 2 years old; in 8 patients the VUR resolved spontaneously. Of the latter, 7 patients (ten refluxing grade III-IV units) are still being followed and awaiting a decision on treatment.


CONCLUSIONS
This study confirms the predominance of boys in those with antenatally suspected vesico-ureteric reflux. The spontaneous resolution or improvement during the first 3 years of life was apparent in most cases, even in those with severe reflux (grade III-V).
Merrot
T
T
Service de chirurgie infantile, pavillon mère-enfant, université de la Méditerranée, CHU Nord, chemin des Bourrelly, 13015 Marseille, France.
Zerhouni
H
H
Chaumoître
K
K
D'Ercole
C
C
Gire
C
C
Alessandrini
P
P
D004108:Dilatation, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D007682:Kidney Pelvis; D008297:Male; D008430:Maternal-Child Health Centers; D011446:Prospective Studies; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000000981:diagnostic imaging*
Le dépistage anténatal des ectasies pyéliques, souvent dues à un reflux vésico-urétéral dépisté après la naissance. Analyse d'une série de 159 dépistages en 4 ans dans une unité mère-enfant.