Prenatal ultrasound for diagnosis and classification of hypospadias
10.3760/cma.j.cn113903-20230805-00083
- VernacularTitle:产前超声对尿道下裂的诊断及分型价值
- Author:
Xiaohua LI
1
;
Wei ZHAO
;
Aqing LIU
Author Information
1. 济宁医学院附属医院超声科，济宁 272000
- Keywords:
Hypospadias;
Prenatal diagnosis;
Ultrasound;
Classification;
Fetus
- From:
Chinese Journal of Perinatal Medicine
2024;27(9):768-773
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic and classification value of prenatal ultrasound for hypospadias.Methods:A retrospective analysis was conducted on fetuses suspected of hypospadias based on prenatal ultrasound, who were treated at the Affiliated Hospital of Jining Medical University from July 2012 to June 2023. Hypospadias was classified as a severe or mild type based on ultrasound images. Postnatal diagnostic conditions of the live-born infants and fetal autopsy findings were obtained, and the diagnostic value and classification consistency of prenatal ultrasound for hypospadias, severe hypospadias, and mild hypospadias were analyzed. Descriptive statistical analysis was used for data analysis.Results:(1) A total of 70 fetuses were included in the study; among them, 64 were singletons (91.4%), and six were twins (8.6%). The maternal age was (31.3±5.1) years, ranging from 21 to 50 years. The gestational age at diagnosis was (29.7±4.5) weeks, ranging from 21 +3 to 39 weeks. Fifteen mothers (21.4%) had a history of early pregnancy preservation (including the six twin pregnancies), nine mothers (12.8%) had previously given birth to fetuses with hypospadias, and four fathers (5.7%) had a history of reproductive surgery (specifics not detailed). Among the 70 cases, 49 (70.0%) were diagnosed with hypospadias after birth and 17 (24.3%) pregnancies were terminated, with a gestational age of (30.2±5.3) weeks, ranging from 26 +4 to 36 weeks. The post-delivery pathological autopsy confirmed hypospadias in all 17 cases, including two isolated hypospadias and 15 combined with other abnormalities. (2) Among the 70 cases, 53 (75.7%) were diagnosed with hypospadias by prenatal ultrasound, including 29 severe and 24 mild cases; the remaining 17 cases were not diagnosed with hypospadias prenatally. Postnatal (post-delivery) diagnosis confirmed hypospadias in 49 cases, including 28 severe and 21 mild cases. Additionally, 21 cases were confirmed to have no hypospadias. (3) A total of 36 cases were detected with hypospadias and other abnormalities by prenatal ultrasound. Among the 28 cases diagnosed with severe hypospadias postnatally (after delivery), 24 cases (85.7%) had other ultrasound abnormalities. Among the 21 cases of mild hypospadias, 12 (57.1%) had other ultrasound abnormalities. Among the 53 fetuses diagnosed with hypospadias prenatally via ultrasound, 46 were confirmed postnatally (after induced labor); out of the 29 cases diagnosed prenatally as severe hypospadias, 27 were confirmed; and among the 24 cases diagnosed prenatally as mild hypospadias, 19 were confirmed. The positive predictive values of prenatal ultrasound for hypospadias, severe hypospadias, and mild hypospadias were 86.8% (46/53), 93.1% (27/29), and 79.2% (19/24), respectively. Among the 49 cases confirmed postnatally (after delivery), three cases (6.1%) were missed by prenatal ultrasound, and seven cases (14.3%) were misdiagnosed by ultrasound, possibly due to the failure to observe the fetal penile tip in detail on the median sagittal plane. Conclusions:Prenatal ultrasound has certain diagnostic and classification values for hypospadias. During the examination, it is necessary to observe the fetal penile tip in multiple planes and comprehensively analyze ultrasound characteristics to improve diagnostic accuracy.
