Prenatal ultrasound diagnosis of fetal urinary system abnormalities

Abstract

Objective To summarize the prenatal ultrasonography characteristics of fetal urinary system abnormalities. And to investigate the clinical value of prenatal ultrasound diagnosis for these malformations. Methods The ultrasound images of 492 cases of fetal urinary system abnormalities detected by prenatal ultrasound were retrospectively analyzed, including associated malformations. Results There were total 548 abnormalities in 492 cases. Some malformations were detected in most cases (84.3%, 415/492), including 232 cases of hydronephrosis (47.2%, 232/492), 100 cases of renal agenesis or atrophy (20.3%, 100/492) and 83 cases of polycystic kidney disease (16.9%, 83/492), while other kinds of malformations were detected in less cases (27.0%, 133/492), including renal dysplasia, ectopic kidney, confluent kidney, renal duplication, renal cyst, megalocystis, ureterocele, urachal diverticulum, OEIS and prune belly syndrome. Only five cases of megacystis were detected in the first trimester and the others were found in the second or third trimester. Three hundred and sixty-six cases (74.4%, 366/492) were isolated urinary system abnormalities, and the other 126 cases (25.6%, 126/492) were combined with one or more other malformations, totally 214 associated abnormalities. Eighty-eight cases (69.8%, 88/126) with other structural malformations were as followings, 22 cardiac abnormalities, 19 digestive system abnormalities, 17 cranial malformations, 12 limbs abnormalities, nine facial malformations and nine spinal abnormalities, still another 34 cases (27.0%, 34/126) with oligohydramnios. During follow-up, five cases were found to be misdiagnosed by prenatal ultrasonography. Two normal cases were misdiagnosed as renal duplication, one adrenal cyst was misdiagnosed as renal cyst, and two cases of ectopic kidney were misdiagnosed as renal agenesis. Conclusion Ultrasonography is a choice in prenatal diagnosis of fetal urinary system abnormalities. It plays an important role in the early detection of these abnormalities and has great significance for clinical diagnosis and treatment. Key words: Ultrasonography, prenatal; Fetus; Urinary system abnormalities