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[Ultrasound screening program for neonates and infants in Hungary]
György Harmat1, György Jójárt, István Rubecz
1Madarász utcai Gyermekkórház és Rendelóintézet, Budapest.
Insights
Ultrasound screening in children detects numerous significant pathological changes, particularly renal and urinary tract disorders. Postnatal screening is crucial, especially if neonatal screening was missed, with follow-up examinations aiding diagnosis.
Area of Science:
- Pediatric imaging
- Diagnostic ultrasound
- Public health screening programs
Background:
- A collaborative ultrasound screening program for children was initiated in 1990 by three Hungarian healthcare facilities.
- The program aimed to identify illnesses, pathological states, and developmental disorders in pediatric populations.
Purpose of the Study:
- To compare ultrasound screening results between neonates and infants.
- To evaluate the efficacy of prenatal versus postnatal screening.
- To analyze the types and prevalence of detected pediatric pathologies.
Main Methods:
- Screenings were conducted using contemporary ultrasound equipment by experienced neonatologists, pediatric radiologists, or pediatricians.
- Data from neonates and infants were systematically collected, compared with clinical findings, and analyzed.
- Computerized data storage and annual evaluations were employed throughout the 10-year study period.
Main Results:
- Over 10 years, 51,688 children were screened, identifying 4,758 pathological cases.
- Renal and urinary tract disorders were the most common findings (3,447 cases).
- Intracranial abnormalities were diagnosed in 1,224 cases, with tumors or cysts in other organs accounting for the remainder.
Conclusions:
- Postnatal ultrasound screening effectively detects numerous pathological changes with significant therapeutic and diagnostic implications.
- Infant screening is vital, particularly when neonatal screening is absent, though follow-up is recommended based on clinical indications.
- Longitudinal documentation from neonatal and infant screenings aids in the accurate diagnosis of later pathological conditions.
Introduction:
A children's hospital in Budapest (The Madarász Street Children's Hospital) and two children's department of two county hospitals (Toldy Ferenc Hospital, Cegléd and Zala County Hospital, Zalaegerszeg) started a common ultrasound screening programme for children in 1990.
Objectives:
This three screening centres agreed which illnesses, pathological states and developmental disorders will be screened. In neonatological departments this screening was carried out usually in the first week of life. In the children's hospital, the majority of measurements was performed between 2 weeks and 3 months of the infants life time. The ratio between this two age group was 43.6 and 56.4%. The authors compared and analysed the results of screenings in neonates and those in infants. Another important objective of the programme was to compare the results of prae- and postnatal screening.
Methods:
Examinations were carried out by up-to-date instruments corresponding to the given period. Data for neonates were compared with those for infants and with clinical findings, analysed, stored in computers and yearly evaluated. Screenings were performed by neonatologists, pediatric radiologists or pediatricians with appropriate practice.
Results:
The three centres examined altogether 51,688 children during their 10-years activity, and found 4758 pathological cases. The majority of pathological cases (3447) was renal and urinary tract disorders, in 1224 cases intracranial occurrences were diagnosed, whereas the remaining cases were mainly tumours or cysts in the liver, spleen or ovarium.
Conclusion:
Numerous pathological changes can be detected by ultrasound screening postnatally, which have great therapeutic significance and are very important for differential diagnostics. By comparing the results for neonates and infants, it can be established that screening in infancy is usually important if no screening was carried out in the neonate age, but control examinations should be performed as well, when it is justified by some physiological or pathological reason. In case of slight deviations, when the first examination cannot provide unambiguous diagnosis, later, repeated examinations can support an accurate diagnosis. Documentation of the results from neonate age and infancy facilitates the correct judgment in later pathological states.