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[Pyelectasy].

B Langer1

  • 1Département de Gynécologie-Obstétrique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, avenue Molière, 67098 Strasbourg Cedex. bruno.langer@chru-strasbourg.fr

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|July 5, 2003
PubMed
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Ultrasonography effectively identifies fetal urinary tract anomalies. Follow-up imaging is crucial for fetal pyelic dilatation, with specific size thresholds guiding postnatal urological exploration for persistent abnormalities.

Area of Science:

  • Medical Imaging
  • Pediatric Urology
  • Prenatal Diagnosis

Background:

  • Fetal pyelic dilatation is a common ultrasonographic finding with uncertain clinical significance.
  • Established guidelines for managing fetal pyelic dilatation are lacking, leading to varied clinical approaches.
  • The role of vesicoureteral reflux (VUR) in isolated fetal pyelic dilatation requires further investigation.

Purpose of the Study:

  • To establish clear ultrasonographic criteria for diagnosing and managing fetal pyelic dilatation.
  • To determine the necessity of postnatal urological exploration based on specific measurements and timing.
  • To clarify the indications for further investigations like voiding cystourethrography and karyotyping.

Main Methods:

  • Retrospective analysis of fetal ultrasonography data.

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  • Application of specific anteroposterior pelvic diameter thresholds (5 mm in the second trimester, 10 mm after 28 weeks).
  • Correlation of prenatal findings with postnatal sonographic controls and urological outcomes.

    • Main Results:

    • A 5 mm threshold in the second trimester requires third-trimester verification.
    • Dilatations exceeding 10 mm after 28 weeks warrant postnatal exploration.
    • Postnatal sonography is recommended, with a follow-up at one month if initially normal.
    • Routine voiding cystourethrography and karyotyping are not indicated for isolated fetal pyelic dilatation.

    Conclusions:

    • Ultrasonography is a key tool for detecting fetal urinary tract anomalies, particularly pyelic dilatation.
    • Management strategies should be based on precise gestational age and measurement thresholds for pyelic diameter.
    • Further research is needed to understand the association between VUR and isolated pyelic dilatation, but routine invasive testing is not currently justified.