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
Institution
Titre
Antenatal and postnatal ultrasound in the evaluation of the risk of vesicoureteral reflux.
Périodique
Pediatric Nephrology
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