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Prenatal Diagnosis of Reno-Urinary Malformations in a Tertiary Center of Republic of Moldavia
Victor Roller1,2, Angela Ciuntu2,3, Elena Țarcă4
1Discipline of Pediatric Surgery, "Nicolae Testemițanu" State University of Medicine and Pharmacy, MD-2004 Chisinau, Moldova.
Insights
Prenatal ultrasound can identify urinary tract anomalies in newborns, enabling early intervention for malformative uropathies. Early diagnosis and targeted management improve outcomes for pediatric kidney disease.
Area of Science:
- Pediatric Urology
- Prenatal Diagnosis
- Medical Imaging
Background:
- Malformative uropathy affects 5-14% of newborns and is often diagnosed late, leading to advanced Chronic Kidney Disease.
- Current diagnostic methods frequently miss congenital urinary tract anomalies until later stages.
Purpose of the Study:
- To identify prenatal urinary tract anomalies, including malformative uropathies, using ultrasound.
- To evaluate the effectiveness of early prenatal diagnosis in managing pediatric renal-urinary abnormalities.
Main Methods:
- Prospective evaluation of 50 children with pyelectasia using prenatal ultrasonography.
- Postnatal clinical and paraclinical examinations were conducted.
- Integration of fetal karyotype and tissue sampling for comprehensive assessment.
Main Results:
- Prenatal diagnosis between 15-22 weeks facilitates early detection of malformative uropathies.
- Combined imaging and genetic techniques aid in revealing complex fetal anomalies.
- Specific demographic and pathological characteristics of affected patients were documented.
Conclusions:
- Early prenatal ultrasonography is crucial for timely diagnosis and management of pediatric uropathies.
- Coordinated prenatal and postnatal care in specialized centers improves survival and investigation for infants with antenatal malformations.
- Timely surgical intervention based on prenatal findings can minimize complications associated with congenital kidney and urinary tract issues.
Abstract:
Malformative uropathy in children is one of the most common pathological conditions, with an incidence of 5-14% in newborns. Recent research shows that even in the current conditions, they are often diagnosed only in the advanced stages, when Chronic Kidney Disease is already affirming. This study's objective is to identify urinary tract anomalies, including malformative uropathies in the prenatal stage, using imaging techniques, namely ultrasound of the pregnant uterus. Using prenatal ultrasonography of the pregnant uterus and postnatal clinical and paraclinical examination, we prospectively evaluated a cohort of fifty children with pyelectasia. We describe the demographic and pathological characteristics of patients diagnosed with renal-urinary abnormalities, as well as their postnatal management. A prenatal diagnosis made during the first 15 to 22 weeks of pregnancy enables the evaluation of early malformative uropathies and the determination of the best time to operate in order to minimize complications. When prenatal ultrasonography, fetal karyotype, tissue sample, and embryonic appendages work together, problems may be partially or entirely revealed by these methods due to mistakes made in imaging examinations. In the case of a pregnancy with an antenatal malformation detected, it is necessary for the delivery to take place in a clinic that can provide favorable services for the survival and investigation of the child born with malformative abnormalities.
