Antenatal and postnatal ultrasound in the evaluation of the risk of vesicoureteral reflux.

Détails

ID Serval
serval:BIB_2D6AAF370E5D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Antenatal and postnatal ultrasound in the evaluation of the risk of vesicoureteral reflux.
Périodique
Pediatric Nephrology
Auteur⸱e⸱s
Grazioli S., Parvex P., Merlini L., Combescure C., Girardin E.
ISSN
1432-198X[electronic], 0931-041X[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
25
Numéro
9
Pages
1687-1692
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Antenatal hydronephrosis (ANH) is a frequent anomaly detected on fetal ultrasound scans. There is no consensus recommendation for the postnatal follow-up and/or the necessity to perform a voiding cystourethrography (VCUG) to diagnose vesicoureteral reflux (VUR). We conducted a cohort/non-randomized trial of 121 patients with ANH, defined as an anterior posterior diameter (APD) >or=5 mm after the 20th week of gestation, to evaluate the ability of the antenatal and postnatal ultrasonography results to predict VUR. All infants had two successive ultrasounds at 5 days and 1 month, respectively, after birth. A VCUG was performed at 6 weeks in children with a persistent APD >or=5 mm and/or an ureteral dilatation observed on at least one of two postnatal ultrasounds. In total, 88 patients had VCUG and nine had VUR, with five having high-grade reflux (>grade II). The risk of VUR increased significantly with the degree of APD detected on the postnatal ultrasound scan (p = 0.03). The odds ratios were 5.0 [95% confidence interval (CI) 0.5-51.2] for APD = 7-9 mm and 9.1 (95% CI 1.0-80.9) for APD >or=10 mm. The results of this study show that among our patient cohort antenatal ultrasound was not predictive of reflux. There was, however, a relation between the importance of the postnatal renal pelvis diameter and the risk of VUR. A cut-off of 7 mm showed a fair ability of ultrasonography to predict VUR and a cut-off of 10 mm enabled all severe refluxes in the 88 patients who had a VCUG to be diagnosed.
Mots-clé
Disease Progression, Female, Gestational Age, Humans, Hydronephrosis/complications, Hydronephrosis/ultrasonography, Infant, Infant, Newborn, Male, Odds Ratio, Predictive Value of Tests, Pregnancy, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Type="Geographic">Switzerland, Ultrasonography, Prenatal, Vesico-Ureteral Reflux/etiology, Vesico-Ureteral Reflux/radiography
Pubmed
Création de la notice
15/02/2011 12:11
Dernière modification de la notice
20/08/2019 13:12
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