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Related Experiment Videos

Screening for fetal urological abnormalities: how effective?

J E Scott1, M Renwick

  • 1The Northern Regional Maternity Survey Office, Newcastle-upon-Tyne, UK. j.e.s.scott@ncl.ac.uk

BJU International
|October 6, 1999
PubMed
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Antenatal ultrasonography shows improved detection of childhood urological conditions, but significant hospital variations persist. Some moderate fetal renal dilatation cases may indicate undiagnosed vesico-ureteric reflux (VUR).

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging
  • Public Health Surveillance

Background:

  • The Northern Congenital Abnormality Survey (NorCAS) tracks congenital abnormalities.
  • Assessing antenatal diagnostic sensitivity for urological conditions is crucial for early intervention.
  • Understanding interhospital variation in diagnosis can improve care standards.

Purpose of the Study:

  • To analyze urological cases from NorCAS to evaluate antenatal diagnostic sensitivity.
  • To measure regional differences in urological abnormality detection among hospitals.
  • To determine the impact of antenatal ultrasonography on preventing childhood urinary tract disease.

Main Methods:

  • Reviewed urological abnormality notifications to NorCAS from 1984-1996.

Related Experiment Videos

  • Analyzed data in two periods (1984-1990 and 1991-1996) to assess changes over time.
  • Calculated expected case numbers per hospital based on birth rates to quantify performance variations.

    • Main Results:

    • Antenatal diagnostic sensitivity for major urological abnormalities improved in the later period.
    • Significant interhospital variation was observed, particularly for antenatal renal dilatation.
    • Moderate fetal renal dilatation (4-10 mm) was associated with vesico-ureteric reflux (VUR) in 8.5% of diagnosed cases.

    Conclusions:

    • Inconsistent recognition of antenatal renal dilatation's significance across hospitals.
    • Potential for missed diagnoses of VUR in children with moderate antenatal renal dilatation.
    • Need for standardized antenatal screening and follow-up protocols for urological abnormalities.