Abstract
Objectives: To describe the natural history of pyelectasis from its detection in the second trimester
to delivery, its capability to predict renal pathology and whether prenatal development
of pelvic dilatation is correlated to its postnatal evolution. Study design: A retrospective analysis involving 375 fetuses with a complete urological follow-up.
Prenatal ultrasound was correlated with the results of postnatal investigation and
frequency of postnatal surgery was established. Results: Two-hundred and eighty cases underwent at least two examinations before birth. 73.1%
were male fetuses. 57.4% had a bilateral pyelectasis. Prenatal evolution of pelvic
dilatation was the following:18.6% of the cases normalized, in 34.6% of the cases
the dilatation reduced but did not disappear, in 30.7% it remained unchanged, while
it worsened in 16.4%. One case from the first group, three cases from the second,
seven cases from the third and 11 cases from the fourth needed surgical treatment.
1.9, 7.2, 18.6, 23.9% of cases respectively worsened after birth in the four groups
(trend: P = 0.001). Conclusions: Prenatal diagnosis of pyelectasis improves the outcome of these children due to a
surgical approach that avoids renal damage. There is a good correlation between prenatal
evolution and postnatal outcome, although a postnatal follow-up is opportune in those
cases that normalized before birth.
Keywords
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Article info
Publication history
Accepted:
April 8,
2004
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
