Korean Journal of Nephrology 1995;14(2):213-220.

산전 초음파 검사로 진단된 선천성 신요로 기형에 대한 추적 관찰

박임재 , 권민중 , 김병길 , 박용원 , 양영호

Abstract

Prenatal ultrasonography provides accurate dete- ction and classification of urinary tract anomalies which make up the majority of prenatal anomalies. Reviewed 39 infants with urinary tract anomalies diagnosed by prenatal ultrasonography in the period 1990 to 1994, and correlative analysis was done between pre and post ultrasonography. Fifteen thousand three hundred and fifty cases of prenatal ultrasonography were performed and among them, 39 cases(0.25%) were diagnosed with urinary tract anomalies. The gestational ages on detection were between 21 to 40 weeks (mean 32 weeks). Mostly, prenatal ultrasonography were perforrned between 31 and 35 weeks. The sex ratio was 4.5:1(M:F). On prenatal ultrasonographic findings, 29 cases(74%) had pelvic dilatation, 9 cases(23%) had cystic diseases and 1 case(3%) had renal mass. Postnatal follow up studies revealed 18 cases(46%) with ureteropelvic junction obstruction, 9 cases(23@Yo) with multicystic dysplastic kidney and 7 cases(18%) had normal kidney. Among the 29 cases with pelvic dilatation on prenatal ultrasonography, 22 cases had AP diameter greater than 10mm. Postnatal ultrasonography was abnormal for these pelvic dilatation of AP diameter greater than 10mm. Other associated anomalies included Turner syndrome, Dandy-Walker syn- drome, cryptorchidism and congenital heart diseases. According to these findings, as non-invasive proce- dure, prenatal ultrasonography is very available for screening of fetal urinary tract anomalies. It is necessary to follow-up persistently after birth when pelvic dilatation of AP diameter greater than 10mm is present prenatally. Therefore, early diagnosis of urinary tract anomalies by prenatal ultrasonography may be able to prevent progression of renal damage and provides immediate management of these infants after delivery.