Evaluation Of The Single Center Results Of Antenatal Renal Pelvic Dilatations

Abstract

Objective

Renal pelvic dilatation is the most common form of the fetal anomalies detected with antenatal ultrasonography. Its reported incidence is 1-5 % of all pregnancies. Different classification systems are used for the determination of the renal pelvic dilatation with imaging systems during the fetal period.The most commonly used parameter for the diagnosis of the renal pelvic dilatation is the measurement of the anteroposterior diameter (APD) of the renal pelvis on the transverse plane.In this study, our objective was to measure the renal pelvic dilatation in the infants of the pregnant women followed up in our hospital and to compare the results with the results in the literature.

Materials and Methods

This study was to evaluate all pregnant women, who applied to the perinatology department between July 2017 and February 2018 and underwent detailed fetal anomaly screening with ultrasound and diagnosed with fetal renal pelvic dilatation following the measurement of the anteroposterior diameter (APD) of the renal pelvis and referred to the consultation with the pediatric surgery.

Results

In 82.7 % (n=57) of the cases, the renal pelvic dilatation was regressed or completely disappeared in the postnatal ultrasonographic examination performed during the follow-up period. However, in 17.3 % (n=12) of the cases, renal pelvic dilatation was still present in the postnatal examinations. Regarding the cases, who were screened for fetal anomalies in the 2nd trimester and diagnosed with renal pelvic dilatation (n=47); 41 cases were in the mild (87.2), 5 in the moderate (10.6%) and 1 case in the high-risk group (2.2%).

Conclusion

A cut-off value of 5 mm is an acceptable measurement value for the diagnosis of renal pelvic dilatation during the 2nd and 3rd trimesters. The parents should be consulted if further investigations become necessary due to the postnatal insistence of the pelvic renal dilatation.

Keywords

• Renal pelvik dilatation,cut off,obstetrik ultrasound

Antenatal Renal Pelvik Dilatasyon ve Fetal sonuçların Gözden Geçirilmesi

Öz

Giriş

Renal pelvis dilatasyonu antenatal ultrasonografi ile en sık tespit edilen fetal anomalilerden biridir. Tüm gebeliklerin yaklaşık %1-5'inde görüldüğü belirtilmektedir. Renal pelvis dilatasyonunun fetal dönemde görüntüleme ile tespit edilmesinde farklı sınıflama sistemleri kullanılmaktadır. Renal pelvis dilatasyonu tanısında genelde renal pelvisin transvers plandaki ön arka çap (ÖAÇ) ölçümüdür. Bu çalışma ile hastanemizde takip edilen gebelerin bebeklerindeki renal pelvis dilatasyonu olgularının ölçüm değerleri ve renal pelvis dilatasyonu tespit edilen olguların kısa dönem takip sonuçlarının literatür ile karşılaştırılması planlanmıştır.

Gereç ve Yöntem

Bu çalışmaya Temmuz 2017 ile Şubat 2018 tarihleri arasında perinatoloji kliniğinde ultrasonografi ile fetal anomali taraması yapılan gebelerin bebeklerinin renal pelvisin transvers plandaki ÖAÇ ölçümü (>5mm) sonucunda renal pelvis dilatasyonu tespit edilerek çocuk cerrahisi kliniğine konsulte edilen olgular çalışmaya dahil edilmiştir.

Bulgular

Renal pelvis dilatasyonu tespit edilen olguların% 82.7'sinin (n=57) doğum sonrası yapılan kontrol ultrasonografi görüntülemesinde renal pelvis dilatasyonun gerilediği veya kaybolduğu, takip edilen olguların %17.3'ünde (n=12) renal pelvis dilatasyonunun doğum sonrasında dadevam ettiği tespit edilmiştir. Fetal anomali taraması sırasında 2.t rimesterde renal pelvis dilatasyonu tespit edilen 47 olgu ölçüm sonuçlarına göre; 41 tanesinin (%87.2) hafif, 5 tanesinin (%10,6) orta, 1 tanesinin (%2,2) ciddi grupta olduğu sınıflandırılmıştır. Üçüncü trimesterde renal pelvis dilatasyonu tespit edilen ve bu dönemde hafif risk grubundaki olguların doğum sonrası yapılan ultrasonografi kontrollerinde dilatasyonun gerilediği görülmüştür.

Tartışma

5 mm'lik kesim noktası değeri 2. ve 3. trimester döneminde renal pelvis dilatasyonu tanısı için geçerli bir ölçüm değeridir. Doğum sonrası renal pelvis dilatasyonunun devam etmesi durumunda ileri tetkiklerin yapılması konusunda ebeveynlere danışmalık verilmesi önemlidir.

Anahtar Kelimeler

• Renal pelvis dilatasyonu,kesim noktası,obstetrik ultrason

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