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Routine fetal genitourinary tract screening.

P H Arger, B G Coleman, M C Mintz

    Radiology
    |August 1, 1985
    PubMed
    Summary
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    Routine fetal ultrasound screening identifies fetuses with potential kidney issues. A renal pelvis larger than 10 mm on ultrasound may indicate significant renal disease, requiring further investigation.

    Area of Science:

    • Obstetrics and Gynecology
    • Pediatric Nephrology
    • Medical Imaging

    Background:

    • Routine prenatal ultrasound screening is crucial for detecting fetal anomalies.
    • Fetal genitourinary tract abnormalities are common, necessitating clear diagnostic criteria.
    • Establishing thresholds for abnormal findings aids in timely intervention.

    Purpose of the Study:

    • To evaluate the effectiveness of routine fetal genitourinary tract ultrasound screening.
    • To determine the specific size of the fetal renal pelvis indicative of significant renal disease.
    • To analyze the clinical and pathological outcomes of fetuses with identified renal pelvis abnormalities.

    Main Methods:

    • Retrospective review of 4,832 obstetrical ultrasound examinations from 3,530 consecutive patients over 2 years.

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  • Identification of fetuses with a renal pelvis >5 mm or a cystic area for follow-up.
  • Categorization of 39 identified fetuses based on renal pelvis size (5-9 mm, >10 mm) and cystic abnormalities, with follow-up ranging from 2 days to 21 months.

    • Main Results:

    • 1.1% of fetuses (39 out of 3,530) met the criteria for follow-up.
    • Fetuses with renal pelves >10 mm were associated with obstructive lesions or exceptional extrarenal pelves.
    • Analysis of clinical and pathological data provided insights into the significance of different findings.

    Conclusions:

    • Routine fetal ultrasound is effective in screening for genitourinary tract anomalies.
    • A fetal renal pelvis size greater than 10 mm is a strong indicator of significant renal disease, potentially requiring intervention.
    • Defined criteria for significant fetal renal hydronephrosis and loculated appearances aid in diagnosis and management.