title: Is screening for vesicoureteral reflux mandatory in infants with antenatal renal pelvis dilatation?
abstract: OBJECTIVE
  To determine whether postnatal ultrasound (US) can guide the use of voiding cystourethrography (VCUG) in infants with antenatally detected renal pelvis dilatation (ARPD).
  
  
  METHODS
  14,000 pregnant women consecutively underwent routine US examination during the second trimester. US examinations later in pregnancy were performed as follow-up of previous anomalies or on obstetrical indications. One hundred and six fetuses with ARPD > or =5 mm were identified. Two postnatal US examinations were performed in the newborns: on the 5th to 7th day and during the 3rd week of life. The findings were considered normal when renal pelvis dilatation (RPD) was < or =7 mm on both US examinations, and no calyceal or ureteric dilatation or signs of renal dysplasia or other anomalies were present. VCUG was done 6 to 8 wk after birth.
  
  
  RESULTS
  In 53 of 103 analysable infants, the postnatal ultrasonographic findings were normal. The VCUG was abnormal in three of these 53 infants, all with vesicoureteral reflux (VUR) grade I. Of 50 infants who had abnormal US examinations, six had VUR, four of which were grade IV and V reflux.
  
  
  CONCLUSIONS
  In infants with ARPD who undergo two postnatal US examinations with RPD < or =7 mm and have no other abnormalities, VCUG is unnecessary.
authors.affiliation: Department of Paediatrics, Karolinska University Hospital, Stockholm, Sweden. karl-johan.lidefelt@karolinska.se
authors.forename: Karl-Johan
authors.initials: KJ
authors.lastname: Lidefelt
authors.forename: Sverker
authors.initials: S
authors.lastname: Ek
authors.forename: Lazlo
authors.initials: L
authors.lastname: Mihocsa
mesh_terms: D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D014463:Ultrasonography; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*