[Isolated fetal pyelectasis: pathologic significance and therapeutic implications]

Area of Science:

• Neonatal Medicine
• Pediatric Urology
• Fetal Medicine

Background:

• Antenatal isolated pyelectasis is a common finding in fetal ultrasounds.
• Understanding its significance and prognosis is essential for appropriate management.

Purpose of the Study:

• To analyze the outcomes of isolated antenatal pyelectasis in neonates.
• To evaluate the association between antenatal findings and postnatal diagnoses.
• To assess the impact on renal function and the need for intervention.

Main Methods:

• Retrospective study of nine neonatal cases with isolated antenatal pyelectasis.
• Exclusion of cases with other congenital abnormalities or fetal demise.
• Analysis of sex, gestational age, echographic findings, antenatal management, and postnatal follow-up.

Main Results:

• Four cases showed transitional pyelectasis, four had ureteropelvic junction obstruction, and one had congenital megaureter.
• Two cases presented with fetal kidney abnormalities and two with oligoamnios.
• Postnatal renal function was decreased in two neonates; two required surgery, and three showed spontaneous regression.

Conclusions:

• Isolated fetal pyelectasis can have significant pathological implications.
• Postnatal renal function, assessed by scintigraphy, is key for determining prognosis and guiding treatment.
• Antenatal management strategies and the necessity of fetal urinary intervention require further clarification.