Peng Liucheng,Zhao Yaowang,Li Chuangye,et al.Predictive value of anteroposterior diameter of renal pelvis in postnatal operation of fetal hydronephrosis[J].Journal of Clinical Pediatric Surgery,,19():218-223.[doi:10.3969/j.issn.1671-6353.2020.03.006]
Predictive value of anteroposterior diameter of renal pelvis in postnatal operation of fetal hydronephrosis
- Keywords:
- Fetal Hydronephrosis; Ureteropelvic Junction Obstruction; Surgical Procedures; Operative; Anteroposterior Diameter of Renal Pelvis
- CLC:
- R726.9;R692.7
- Abstract:
- Objective To explore the diagnostic value of anteroposterior diameter (APD) of renal pelvis for fetal hydronephrosis during follow-ups.Methods The clinical data were analyzed retrospectively for fetal hydronephrosis with APD greater than or equal to 4 mm in the second trimester or 7 mm in the third trimester as detected by prenatal ultrasound at Hunan Children’s Hospital and Hunan Maternal & Children’s Health Hospital from June 2017 to December 2018.During follow-ups,the postnatal outcome of children with fetal hydronephrosis was divided into operative and non-operative groups.Results A total of 98 children (161 kidneys) were included and 36 children (40 kidneys) underwent pyeloplasty because of operative indications.Multivariate Logistic regression analysis showed that APD values in the second trimester,the third trimester and the first postnatal month were risk factors for pyeloplasty in children with hydronephrosis.The optimal critical values of APD in the second trimester,the third trimester and the first postnatal month were 7.5,16.4 and 15.5 mm with a sensitivity of 75.7%,70.3% and 83.8% and a specificity of 79.0%,90.0% and 87.0% respectively.When APD were 7.5 mm in the second trimester,16.4 mm in the third trimester or 15.5 mm in the first postnatal month,the sensitivity and specificity of pyeloplasty were 91.9% and 85.0% respectively.Conclusion APD in the second trimester,the third trimester and the first postnatal month may predict the risk of pyeloplasty.The last two periods can better predict the optimal critical value of postnatal operation for ureteropelvic junction obstruction (UPJO) children.However,children with a high operative risk may be screened in the second trimester.A combination of fetal and postnatal APD can be employed as a screening tool of improving the accuracy of predicating pyeloplasty in UPJO children.
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Memo
收稿日期:2019-12-22。
基金项目:湖南省卫生与计划生育委员会科研项目（编号：B2014-125）
通讯作者:赵夭望,Email:yw508@sina.com