Multivariate analysis of outcome of fetal hydronephrosis based on the grading system of prenatal and postnatal urinary tract dilation
10.3760/cma.j.issn.2095-428X.2019.17.008
- VernacularTitle: 基于泌尿系统扩张分级系统对影响胎儿肾积水转归的多因素分析
- Author:
Daorui QIN
1
;
Wei TIAN
2
;
Xueming JU
3
;
Yu MAO
1
;
Xuejun WANG
1
;
Yu LIU
1
,
4
;
Yunman TANG
1
Author Information
1. Department of Pediatric Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China
2. Department of Operation Management, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China
3. Department of Ultrasound, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072, China
4. Graduate School, Zunyi Medical University, Zunyi 563003, Guizhou Province, China
- Publication Type:Journal Article
- Keywords:
Hydronephrosis;
Prenatal diagnosis;
Fetus;
Prognosis;
Ultrasonography
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(17):1313-1316
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the reliability and validity of the Urinary Tract Dilation (UTD) classification system as a new grading system for fetal hydronephrosis, and analyze the risk factors for prognosis of fetal hydronephrosis.
Methods:The data of patients who presented with fetal hydronephrosis from January to July 2016 at Sichuan Aca-demy of Medical Sciences & Sichuan Provincial People′s Hospital were retrospectively reviewed.The outcome of the patients who were treated with surgery or without surgical treatment was recorded if they were older than 2 years old.All renal nephrons were regraded if UTD classification system had been used for antenatal hydronephrosis assessment reliability previously.Univariate and multivariate analysis was performed to analyze the risk factors for prognosis of fetal hydronephrosis.
Results:A total of 94 patients (136 renal nephrons) were eligible for enrollment.During the observation period, 43 kidneys received surgery which had clinical indications for surgery, and the remaining 93 kidneys without surgery were stable until the end of the observation period.Ultrasound finding of fetal hydronephrosis in the second trimester were graded according to UTD grading system.Among the 51 kidneys with UTD A1, 7 kidneys (13.73%) received surgery during the observation period, and 35 kidneys (47.30%) received surgery during the observation period among 74 kidneys with UTD A2-3.In the third trimester of pregnancy, among 54 kidneys with UTD A1, 3 kidneys (5.56%) were operated during the observation period, and among 82 kidneys with UTD A2-3, 40 kidneys (48.78%) were operated during the observation period.Multivariate analysis revealed that parenchymal thickness before 32 weeks and UTD classification system during the third trimester of pregnancy were risk factors for fetal hydronephrosis which required surgical treatment after birth.
Conclusions:The UTD classification system is reliable for the evaluation of fetal hydronephrosis and is valid in predicting surgical intervention.Parenchymal thickness before 32 weeks and grading UTD A2-3 after 32 weeks is a risk factor for postnatal surgery.Analysis of fetal hydronephrosis data based on UTD grading system and standardized follow-up are helpful to control the risk of fetal hydronephrosis effectively.
