Pitfalls of Prenatal Ultrasound Screening in Diagnostics of Serious Inborn Developmental Defects of the Kidney and Urinary Pathways
Authors:
H. Flögelová 1; O. Šmakal 2; J. Hálek 3,4; K. Michálková 5; P. Geier 1; P. Koranda 6; L. Doubrava 3; V. Janout 7
Authors place of work:
Dětská klinika LF UP a FN, Olomouc
přednosta prof. MUDr. V. Mihál, CSc.
1; Urologická klinika LF UP a FN, Olomouc
přednosta doc. MUDr. V. Študent, Ph. D.
2; Novorozenecké oddělení FN, Olomouc
primář MUDr. L. Kantor, Ph. D.
3; Ústav lékařské biofyziky a biometrie LF UP a FN, Olomouc
ředitel prof. ing. J. Hálek, CSc.
4; Radiologická klinika LF UP a FN, Olomouc
přednosta doc. MUDr. M. Heřman, Ph. D.
5; Klinika nukleární medicíny LF UP a FN, Olomouc
přednosta doc. MUDr. M. Mysliveček, Ph. D.
6; Ústav preventivního lékařství LF UP a FN, Olomouc
ředitel prof. MUDr. V. Janout, CSc.
7
Published in the journal:
Čes-slov Pediat 2008; 63 (11): 606-613.
Category:
Original Papers
Summary
Introduction:
Inborn developmental defects of the kidney and urinary pathways are frequent and their late diagnosis is associated with the risk of complications, which may results in serious affection of kidney function.
Objective:
The aim of this prospective study in to evaluate sensitivity of prenatal ultrasound screening in the detection of severe inborn developmental defects of the kidneys.
Materials and methods:
In 3,269 children, born at the Faculty Hospital in Olomouc in the period of 1st January 2005 through 31st December 2006 (the primary cohort), who underwent common prenatal ultrasound screening, were examined by postnatal ultrasound US) of the kidneys. Children with pathological findings of dilatation during prenatal US and/or those with dilatation of the renal pelvis in anterior-posterior (AP) projection ≥5 mm in postnatal US examination were further subjected to follow-up examinations and, when necessary, underwent urological examination. The authors evaluated the frequency of occurrence of severe defect of the kidney requiring surgical treatment in the primary cohort and the frequency of pathological finding of dilatation of the hollow system of the kidney during screening of these children.
Results:
In 12 children (0.36%) of the primary group there was a sufficiently severe kidney defect that a surgical solution was indicated. Four of these 12 children had a normal finding in the prenatal US examination, and all of the 12 children had a pathological finding during the postnatal examination. Sensitivity of the postnatal screening was 66.7%; 95% CI for sensitivity proved to be 34.9% to 90.1%.
Conclusion:
In the cohort there were a relatively high percentage of children with significant defect of the kidneys, who had not been detected during prenatal US. These results should be considered as preliminary, the study relating prenatal and postnatal US screening is still in progress. Only on the basis of a high number of examined children in the following years a final statistical processing will be performed and recommendation for effective improvement of diagnostics of inborn kidney defections will be created.
Key words:
inborn developmental defects of the kidney, prenatal and postnatal ultrasound screening
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2008 Číslo 11
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