Hydronephrosis during pregnancy: how to make a decision about the time of intervention?
OBJECTIVE
To evaluate the role of doppler ultrasonographorin managing hydronephrosis during pregnancy.


METHODS
The study included 27 pregnant patients with unilateral symptomatic persistent hydronephrosis (group 1) and 38 pregnant patients with physiological hydronephrosis of pregnancy (group 2). All pregnant patients underwent Doppler Ultrasonography to determine the Resistive Index (RI) and the difference between the RI of the corresponding and contralateral kidney (Delta Resistive Index = delta RI).


RESULTS
There were no statistical differences between the two groups in terms of age, mean gestational period, or number of pregnancies. The mean renal RI of the hydronephrosis side was 0.68 ± 0.05 in group 1 and 0.60 ± 0.05 in group 2 (p less than 0.001). The mean delta RI of group 1 was significantly higher than the mean delta RI of group 2 (0.07 ± 0.03 versus 0.02 ± 0.01, respectively, p less than 0.001). The RI and delta RI were considered positive with values of more than 0.70 and more than 0.04, respectively, and the RI was sensitive in 44.4% and specific in 92.1% for intervention treatment. The corresponding values for delta RI were 88.9% and 89.5%. The positive predictive value and negative predictive value of delta RI for intervention were 85.7% and 91.9%, respectively.


CONCLUSIONS
It is much better to consider delta RI than RI when deciding on interventional treatment in hydronephrosis during pregnancy.
1Department of Urology, University of Dicle, 2Department of Gynecology and Obstetrics, University of Dicle, 3Department of Radiology, Diyarbakir Obstetrics and Gynecology and Children Diseases Hospital, 4Department of Radiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
Mehmet
M
Nuri Bodakci
Namik
N
Kemal Hatipoglu
Ali
A
Ozler
Abdulkadir
A
Turgut
Cihad
C
Hamidi
Nebahat
N
Hatipoglu
Bircan
B
Alan
D000328:Adult; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055815:Young Adult