ESPN 50th Annual Meeting

ESPN 2017


 
Inherited urinary tract disorders diagnosed due to neonatal ultrasonographic screening
TOMASZ JARMOLIńSKI 1 BARBARA MARSZALSKA 2 HANNA MARCINIAK 1 JOANNA SZCZEPANIK-BOROń 3

1- DEPT. OF PEDIATRICS, REGIONAL HOSPITAL, MIęDZYRZECZ, POLAND
2- DEPT. OF NEONATOLOGY, REGIONAL HOSPITAL, MIęDZYRZECZ, POLAND
3- DEPT. OF RADIOLOGY, REGIONAL HOSPITAL, MIęDZYRZECZ, POLAND
 
Introduction:

Neonatal abdominal ultrasonography (US) is an easy and safe method of diagnosis of congenital urinary tract abnormalities. In the era of antenatal examinations, it is not routinely recommended. The aim of the study was to estimate the frequency and type of CAKUT and other urinary tract disorders found in ultrasonographic screening performed in regional neonatal unit.

Material and methods:

During last 3 years (March 2014 - March 2017) 941 out of 1153 neonates born in our hospital (87%) had US performed by the same radiologist or nephrologist. Children with abnormal urinary tract (renal pelvis A-P diameter > 5mm, dilated ureter, abnormal volume and/or echogenicity of the kidney, renal cysts) were followed up in nephrological outpatient till the final diagnosis. US was repeated in 4-6 weeks and then every 3 months and other imaging techniques (voiding cystourethrography, radioisotopes and intravenous pyelography) ordered when needed.

Results:

165 neonates were transferred to the clinic for abnormalities found in the first US. Among them 18 finally presented with various kinds of CAKUT: 5 –hydronephrosis (1 – bilateral), 5 – megaureter (2 – bilateral), 2 – hypoplastic kidney, 2 – posterior urethral valves (PUV), 2 – multicystic dysplastic kidney, single cases of segmental renal dysplasia and horshoe kidney with hydronephrosis and 1 with ADPKD (2,0% of all neonates included into the study and 11,5% of those with abnormal postnatal US). Only 5 of these children (26,3%) had any data about abnormal prenatal USG, neither ADPKD nor PUV patients among them.

Conclusions:

Neonatal US is a key procedure in early diagnosis of CAKUT and other structural abnormalities of urinary tract even in the cases with normal intrauterine US. For it is safe, easy and cheap one could introduce US screening into routine examination of neonates, especially in regions with poor standard of prenatal care.