Hafif ve Orta Dereceli İzole Antenatal Hidronefrozlu Süt Çocuklarının Postnatal İzlem Sonuçlarının Değerlendirilmesi

Year 2019, Volume: 41 Issue: 1, 17 - 22, 01.01.2019

Nuran Çetin

https://doi.org/10.20515/otd.425849

Abstract

Antenatal hidronefroz
doğum öncesi yapılan ultrasonografik incelemede en sık saptanan konjenital
ürolojik anomalilerden biridir. Hafif ve orta dereceli izole antenatal
hidronefrozun doğum sonrası dönemdeki yönetimi hakkında çelişkili sonuçlar
bulunmaktadır. Bu çalışmanın amacı hafif ve orta dereceli izole antenatal
hidronefrozlu süt çocuklarında ilk bir yılda idrar yolu enfeksiyonu (İYE)
sıklığını ve klinik seyri araştırmaktır. Bu çalışmaya doğum sonrası 7 gün ile 2
hafta arasında yapılan ilk böbrek ultrasonografisinde hafif ve orta dereceli
hidronefrozu olan hastalar dahil edildi. Hidronefroz dışında böbrek anomalisi
olan, üreteral dilatasyonu ya da mesane
anomalisi bulunan hastalar çalışmaya dahil edilmedi. Hidronefroz ön-arka pelvis
çapı ölçülerek hafif (5-9.9 mm) ve orta (10-14.9 mm) dereceli olarak
sınıflandırıldı. Çalışmaya 140 hasta
[96 erkek (%68.6), 44 kız (%31.4)] dahil edildi. Altmış hasta (%42.9) hafif
dereceli, 80 hasta (%57.1) orta dereceli hidronefroza sahipti. Spontan gerileme
oranı hafif hidronefrozlu hastalarda diğer gruptan daha yüksekti [sırası ile
n=58 (%96.6), n=48 (%60), p<0.01]. Ortanca gerileme zamanı hafif hidronefrozlu
hastalarda daha kısa idi [ortanca gerileme zamanı; sırası ile 4 (3-5.25); 6
(5-7) ay,  p<0.01]. İYE sıklığı hafif
ve orta dereceli hidronefrozlu hastalar arasında farklı değildi (p>0.05). Hafif ve orta dereceli izole hidronefroz sıklıkla
kendini sınırlayan bir durumdur. Hafif ve orta dereceli izole hidronefrozlu
çocuklar antibiyotik profilaksisi başlanmadan izlenebilir.

 

Keywords

İdrar yolu enfeksiyonu, antibiyotik profilaksisi, izole antenatal hidronefroz

The Evaluation of Postnatal Follow-up Results of the İnfants with Mild and Moderate İsolated Antenatal Hydronephrosis

Abstract

Antenatal hydronephrosis is
one of the most common congenital urological anomalies identified on prenatal ultrasound. There
are controversial results in the postnatal management of mild-moderate isolated antenatal hydronephrosis. The
purpose of this study was to investigate the clinical outcome and the frequency
of urinary tract infection in infants with mild-moderate
isolated antenatal hydronephrosis during the first year of life.
The patients with mild-moderate hydronephrosis on the first renal
ultrasonography done between seven days and two weeks of age were included in
this study. The patients with other kidney abnormalities other than
hydronephrosis, ureteral dilatation or bladder abnormalities were not included
in the study. Hydronephrosis was classified as mild (5-9.9 mm), moderate
(10-14.9 mm) by anterior-posterior pelvic diameters.  140 patients [96 boys (68.6%), 44 girls
(31.4%)] were included in the study. Sixty (42.9%) patients had mild
hydronephrosis and 80 (57.1%) patients had moderate hydronephrosis. The rate of
spontan resolution was higher in patients with mild hydronephrosis than other
group [n=58 (96.6%), n=48 (60%), respectively, p<0.01]. The median
regression time was shorter in patients with mild hydronephrosis [median
regression time; 4 (3-5.25); 6 (5-7) months, respectively,  p<0.01]. The frequency of urinary tract
infection did not differ between the patients with mild and moderate
hydronephrosis patients (p>0.05). There was no evidence of acute
pyelonephritis and obstructive or progressive hydronephrosis. Mild and moderate
isolated antenatal hydronephrosis is often a self-limited condition. Children
with mild and moderate isolated antenatal hydronephrosis might be followed
without antibiotic prophylaxis.

Keywords

Urinary tract infection, antibiotic prophylaxis, isolated antenatal hydronephrosis

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