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Moderate and severe fetal pyelectasis: Correlation between prenatal aspects and postnatal outcome
C Loardi1, M Signorelli1, M Gregorini1
1Department of Obstetrics and Gynecology, Prenatal Diagnosis Unit, ASST Spedali Civili Brescia, University of Brescia, Italy.
Journal of Neonatal-Perinatal Medicine
|October 15, 2019
Summary
Prenatal detection of moderate to severe renal pelvic dilatation (RPD) often indicates postnatal renal damage. Close follow-up and prenatal counseling are crucial for managing RPD outcomes.
Area of Science:
- Pediatric Urology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Renal pelvic dilatation (RPD) is a common finding during fetal ultrasounds.
- Prenatal detection of moderate and severe pyelectasis requires correlation with postnatal outcomes.
Purpose of the Study:
- To correlate prenatally detected moderate and severe renal pelvic dilatation with postnatal outcomes.
- To assess the predictive value of prenatal ultrasound for postnatal renal function and management.
Main Methods:
- Retrospective analysis of 90 cases with moderate to severe RPD.
- Correlation of prenatal ultrasound findings with postnatal renal function (creatinine, scintigraphy).
- 18 months of urological follow-up for all cases.
Main Results:
- 38.9% of cases required surgery; 61.1% were managed conservatively.
- Higher median RPD in the surgical group (18 mm) vs. conservative group (11 mm).
- 25% risk of surgery for moderate RPD, increasing to 60% for severe RPD; 39% developed irreversible renal impairment.
Conclusions:
- Moderate and severe RPD frequently correlate with postnatal renal damage.
- Prenatal ultrasound is highly predictive of postnatal outcomes.
- Close multidisciplinary follow-up and prenatal counseling are essential for managing RPD.
