Third trimester ultrasound of fetal pyelectasis: Predictor for postnatal surgery

Thornburg, Loralei L.; Pressman, Eva K.; Chelamkuri, Satya; Hulbert, William; Rabinowitz, Ronald; Mevorach, Robert

doi:10.1016/j.jpurol.2007.04.005

« Previous Next »Journal of Pediatric Urology
Volume 4, Issue 1 , Pages 51-54, February 2008

Third trimester ultrasound of fetal pyelectasis: Predictor for postnatal surgery☆

Loralei L. Thornburg
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester, 601 Elmwood Avenue, Box 668, Rochester, NY 14642, USA
- Corresponding author. Tel.: +1 585 275 7480; fax: +1 585 256 1416.
Eva K. Pressman
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester, 601 Elmwood Avenue, Box 668, Rochester, NY 14642, USA
Satya Chelamkuri
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester, 601 Elmwood Avenue, Box 668, Rochester, NY 14642, USA
William Hulbert
- Department of Pediatric Urology, University of Rochester, 601 Elmwood Avenue, Box 655, Rochester, NY 14642, USA
Ronald Rabinowitz
- Department of Pediatric Urology, University of Rochester, 601 Elmwood Avenue, Box 655, Rochester, NY 14642, USA
Robert Mevorach
- Department of Pediatric Urology, University of Rochester, 601 Elmwood Avenue, Box 655, Rochester, NY 14642, USA

Received 10 April 2007; accepted 18 April 2007. published online 11 June 2007.

Abstract

Objective

The ability to predict surgically relevant fetal renal pyelectasis is limited. We sought to determine whether the intrauterine timing of prenatal pyelectasis can predict the need for postnatal surgery.

Methods

We retrospectively reviewed all patients with ultrasound measurements of the fetal renal pelvis during the 2nd and 3rd trimesters and postnatally. Pyelectasis was defined as >7mm for renal pelvis antero-posterior diameter in the 2nd trimester and >10mm in the 3rd trimester.

Results

Fifty-nine patients out of 2397 candidates met the criteria for inclusion. A total of 116 kidneys were analyzed independently. Second trimester pyelectasis was associated with grade of postnatal hydronephrosis but not the need for surgery. Third trimester pyelectasis was associated with both postnatal hydronephrosis and surgery. The positive and negative predictive values for postnatal surgery were respectively 18% and 95% in the second trimester, and 27% and 100% in the third trimester.