Antenatal diagnosis and outcome of congenital anomalies of the kidneys and urinary tract

摘要

Ultrasound screening during pregnancy has resulted in increasing recognition of fetal hydronephrosis. Congenital anomalies of the kidney and urinary tract (CAKUT) represent 20% to 30% of all antenatally diagnosed fetal congenital anomalies in developed countries (1), Depending on diagnostic criteria and gestation, the prevalence of antenatally detected hydronephrosis (ANH) ranges from 0.6 to 4.3%. Objective: To study the outcome of different types of CAKUT diagnosed during the antenatal period especially hydronephrosis that identified primarily in the 3 rd trimester. Materials and Methods: This is a prospective study; all fetuses diagnosed antenatally with urinary tract anomalies are studied for prevalence, pattern of distribution during 2 nd and 3 rd trimesters by ultrasound and followed 6 weeks after delivery. The cases was examined at the Prenatal Diagnosis and Fetal Medicine Department, National Research Centre, Al Hussien Maternity and Bab El Shaareyia Maternity Hospitals, Al Azhar University, Cairo, Egypt, through a period of 18 months, Results: Forty one fetuses with urinary tract anomalies from 640 pregnant women were antenatally diagnosed. The most common abnormalities detected were hydronephrosis, polycystic kidney disease and multicystic dysplastic kidney in descending order of frequency. Moderate and severe hydronephrosis needs more investigation and surgical intervention. Male neonates are at a high risk for post natal hydronephrosis. Conclusions: Antenatal diagnosis of CAKUT is a helpful tool in immediate postnatal care and help in early identification of patients who need early surgical intervention. In addition, Moderate Hydronephrosis is associated with high risk of postnatal hydronephrosis.