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[Prenatal diagnosis of abnormalities of the urinary tract]
P Vilits1, E Ring, P H Petritsch
1Universitätsklinik für Urologie, Graz.
Insights
Prenatal screening detected 166 urinary tract malformations in infants, predominantly in boys. Early detection, especially for ureteropelvic obstruction, is crucial, with many requiring surgery shortly after birth.
Area of Science:
- Pediatric Urology
- Prenatal Diagnosis
- Medical Imaging
Context:
- Urinary tract malformations (UTMs) pose significant health challenges in newborns.
- Prenatal diagnosis allows for early identification and management planning.
- A 10-year retrospective study analyzed cases of suspected and confirmed UTMs.
Purpose:
- To evaluate the incidence and types of prenatal urinary tract malformations.
- To determine the necessity and types of surgical interventions required.
- To emphasize the importance of prenatal screening for obstructive uropathy and multicystic-dysplastic kidney.
Summary:
- 166 cases of UTMs were identified prenatally and confirmed postnatally between 1983 and 1993.
- Boys constituted 72% of cases, with unilateral malformations occurring in 66%.
- Ureteropelvic obstruction was the most common diagnosis (45%), necessitating surgical intervention in 44% of infants.
Impact:
- High rates of surgical intervention, including temporary diversions and definitive corrections, highlight the severity of these conditions.
- Prenatal screening is vital for early detection and management of obstructive uropathy and multicystic-dysplastic kidney.
- Vesicoureteral reflux often requires postnatal diagnosis following urinary tract infections.
Abstract:
During the period January 1983 to December 1993 malformations of the urinary tract were suspected in 166 cases prenatally and confirmed after birth. Boys dominated (72% of cases); in 66% of the cases the malformation was unilateral. The most frequent diagnosis was ureteropelvic obstruction in 74 infants (45%). 73 out of 166 infants (44%) required surgical intervention. Altogether 124 operations were performed (68% temporary diversions; 32% definitive corrections). The high number of required interventions already during the first month of life highlights the importance of prenatal screening for the early detection of urinary tract malformations, especially obstructive uropathy and multicystic-dysplastic kidney. On the other hand, vesicouretal reflux is usually detected only postnatally on investigation of a urinary tract infection.