Ultrasound screening of congenital urinary defects and its prospects in Slovakia

Abstract

The main purpose of the neonatal sonographic screening of the urinary system is to find defects that need to be resolved in the neonatal period or early infancy. Objective: to establish the incidence and structure of congenital malformations in Slovakia and retrospectively determine the proportion of prenatal diagnostics in the revealing congenital malformations of the urinary system in the Slovak Republic during the last decade. Materials and methods. In total 38,496 newborns were enrolled in the research, representing 66.5% of the total population of 57,969 newly-born children in 2017. In cooperation with the National Center for Health Information, we have found other statistical data. Results. Grade 1 of the pelvicalyceal system dilatation according to Hofmann's classification occured in 7%, grade 2 in 0.53%, grade 3 in 0.21%, and grade 4 in 0.1% of cases. One-sided agenesis occured in about 0.1% of patients. Renal cysts of various etiologies revealed in about 0.05% of children. During the selected years, the proportion of the prenatal diagnosis of congenital developmental defects of the urinary system increased from 13.3% in 1995 to 29.1% in recent years (an average of 24.4%). Conclusions. The incidence rate of congenital urinary malformations requiring nephrological and urological care and often intervention of urologist as early as in the neonatal period composes 31 out of 10,000 children. The prenatal diagnosis currently used in Slovakia finds only one quarter of congenital developmental defects of the urinary system. The high incidence rate, low-level coverage of prenatal diagnostic screening, history and physical examination, absence of a urinary infection in some forms and poor prognosis of the urinary pathology are clear arguments for the implementation of screening in all neonatal departments of the Slovak Republic.