Postnatal Ultrasound Examination Research Articles

Sporadic form of Glomerulocystic Kidney Disease in a Child: A Case Report

Abstract Glomerulocystic kidney disease (GCKD) is a rare form of cystic renal disease. We report a four-week-old baby girl born to non-consanguineous parents; their antenatal third-trimester ultrasound showed severe oligohydramnios that required amnioinfusion. Post-natal ultrasound examination showed few tiny cysts (2-3mm) involving the cortices in bilateral kidneys. Kidney biopsy showed dilatation of Bowman’s space and cystically dilated glomeruli, suggestive of GCKD. Whole exome sequencing revealed no pathogenic or likely pathogenic variant.

P-757 The classification and management of adnexal masses identified during pregnancy

Abstract Study question How do we classify adnexal masses (ovarian cysts) identified during pregnancy and how should we manage them? Summary answer Adnexal masses (ovarian cysts) should be managed expectantly in pregnancy, given the low rate of complications and low prevalence of malignancy. What is known already Conservative management of adnexal masses (ovarian cysts) is preferable during pregnancy, due to the maternal and fetal risks associated with surgery. Accurate diagnosis is key to safe expectant management. Various ultrasound-based models exist to classify adnexal masses; however, none have been validated for use in pregnancy. Adnexal mass morphology can change during pregnancy due to decidualisation, which is often difficult to distinguish from underlying neoplastic processes. We aim to evaluate:(1) the performance of current methods of adnexal mass classification in pregnancy, (2) understand the natural course of adnexal masses in pregnancy, particularly the presence of decidualisation and incidence of complications. Study design, size, duration Retrospective analysis of prospectively collected data between January 2017- November 2022. To classify adnexal masses (ovarian cysts), we evaluated: Expert subjective assessment (SA), IOTA Simple Rules (SR) and the IOTA Assessment of Different Neoplasias of the Adnexa (ADNEX) model. The end point was either the histological examination of tissue removed at surgery or the subjective classification of adnexal masses at the postnatal scan in women managed conservatively. Participants/materials, setting, methods Women with an adnexal mass identified on gynaecological ultrasound in pregnancy at a tertiary London University Hospital were included. Relevant clinical data was extracted, including age, gestation and cyst-related complications. Adnexal masses were classified at the first antenatal and postnatal ultrasound examination according to SA, SR and the ADNEX model (10% risk of malignancy cut off) and correlated to histology for adnexal masses managed surgically. IOTA simple descriptors were used to classify benign adnexal masses. Main results and the role of chance 254 women (median age 33-years old, range:18-49) with an adnexal mass/cyst were included at a median gestation of 12 weeks, (range:4-36). 13 (5.1%) conceived through assisted reproductive techniques. Spontaneous resolution occurred in 24.5% of cases, and 21 were lost to follow up (8.3%). According to Simple Descriptors, 38.6% were simple, 22.0% were endometriomas and 19.7% were dermoid cysts. Antenatally, SA outperformed ADNEX, based on specificity (94.6 vs.92.2%) and sensitivity (60 vs.55.6%) respectively. SA and ADNEX had a negative predictive value(NPV) of 96.1% and 98.3% respectively. Postnatally, SA had a higher sensitivity than ADNEX (75 vs.50%), but a lower specificity (94.1 vs.96.9%). SA and ADNEX had a NPV of 94.1% and 97.5% respectively. Three (1.3%) underwent acute surgery during pregnancy: one ovarian torsion (9/40), and two cyst ruptures (11/40, 30/40). Presumed decidualisation occurred in 29.5% of endometriomas. Three (1.3%) underwent cyst removal during caesarean section, two for suspicion of BOTs (one had suspected decidualisation) and one for patient preference. On histology, the suspected decidualised mass was a serous BOT, and the suspected BOT was a struma ovarii. In the postnatal period (12 weeks), four underwent surgery for suspicion of BOTs, two were confirmed BOTs and two were benign cystadenomas on histology. Limitations, reasons for caution The dataset as expected contains a relatively small number of malignancies (prevalence 3.9%) and so any analysis of test performance to discriminate between benign and malignant disease must be interpreted with caution. A larger prospective multicentre study is needed to do this. Wider implications of the findings Our data suggest that a number of cysts in pregnancy will resolve, a few will be associated with acute complications and the risk of malignancy is very low. Accordingly, the study supports an expectant management approach for adnexal masses (ovarian cysts) detected in pregnancy. Trial registration number Not applicable

The ‘Ironclad friendship’ of China-Cambodia, lays the first step in the foundation of early diagnosis and treatment of asymptomatic congenital heart Defects- A multi-national screening and intervention project, 2017–2020

BackgroundCongenital heart disease (CHD) is the leading cause of mortality in childhood worldwide. However, a large number of children with CHD are not diagnosed promptly in low- and middle-income regions, due to limited healthcare resources and lack the ability of prenatal and postnatal ultrasound examinations. The research on asymptomatic CHD in the community is still blank, resulting in a large number of children with asymptomatic CHD can not be found and treated in time. Through the China-Cambodia collaborative health care initiative, the project team conducted research, screened children’s CHD through a sampling survey in China and Cambodia, collected relevant data, and retrospectively analyzed the data of all eligible patients.ObjectivesThe project aimed to evaluate the prevalence of asymptomatic CHD in a sample population of 3-18years old and effects on their growth status and treatment outcomes.MethodsWe examined the prevalence of ‘asymptomatic CHD’ among 3-18years old children and adolescents at the township/county levels in the two participating. A total of eight provinces in China and five provinces in Cambodia were analyzed from 2017 to 2020. During 1 year follow-up after treatment, the differences in heights and weights of the treated and control groups were evaluated.ResultsAmong the 3,068,075 participants screened from 2017 to 2020, 3967 patients with asymptomatic CHD requiring treatment were identified [0.130%, 95% confidence interval (CI) 0.126 -0.134%]. The prevalence rate of CHD ranged from 0.02 to 0.88%, and was negatively related to local per capita GDP (p = 0.028). The average height of 3310 treated CHD patients were 2.23% (95% CI: -2.51%~-1.9%) lower than that of the standard group and the average weight was − 6.41% (95% CI: -7.17%~-5.65%) lower, the developmental gap widening with advancing age. One year after treatment, the relative height difference remained comparable while that, in weight was reduced by 5.68% (95% CI: 4.27% ~7.09%).ConclusionsAsymptomatic CHD now is often overlooked and is an emerging public health challenge. Early detection and treatment are essential to lower the potential burden of heart diseases in children and adolescents.

Laparoscopic treatment of pyloric atresia in a newborn

Introduction. Pyloric atresia is one of the rarest surgical diseases in newborns. Laparotomy is the most common modality for correcting this abnormality. In modern scientific literature, there is only one report on the endosurgical treatment of pyloric atresia. The case of laparoscopic correction of gastric outlet atresia presented in this study is one more reference to the successful care of this condition.Material and methods. The presented clinical case is a newborn boy in whom a prenatal ultrasound examination at the 31st week of gestation revealed polyhydramnios and an enlarged stomach. The baby’s birth weight was 2660 grams. In the first hours of life, the child showed symptoms of high intestinal obstruction in the form of gastric content vomiting. Postnatal ultrasound and X-ray examination confirmed the diagnosis of pyloric atresia. During laparoscopy, performed on the 2nd day of life, the morphological type of anomaly was examined, and the type I atresia of membranous form was established. A laparoscopic membranectomy with Heineke–Mikulicz pyloroplasty was performed. In the final part of this research, early and late outcomes of the performed surgical treatment were analyzed.Results. The surgery lasted for 70 min. Postoperative period was uneventful. Enteral nutrition started on day 3 after the surgery. A complete enteral diet was possible on day 7. The newborn patient was discharged from the hospital on the 9th postoperative day. Histological examination confirmed the pyloric atresia of membranous type. During 12-month follow-up, no complications associated with the surgical procedure were seen.Conclusion. The described case of laparoscopic treatment of type I pyloric atresia in a newborn expands laparoscopy application in pediatric practice.

A case report of large hydrometrocolpos in neonate

2hrs old female, delivered at 38 weeks of gestation with abdominal distension with antenatal Ultrasound suggestive of 12*6 cm cystic mass in lower abdomen, mild hydronephrosis, Bilateral Renal pyelectesis. On examination she had lower abdominal distension, vulval oedema, lower limb oedema and also all four limb polydactyly. Post-natal Ultrasound examination revealed the presence of hypoechoic and corpusculated 12*6 cm cystic lesion in the midline with thick wall in continuity with vagina suggestive of Large hydro- metracolpos with bilateral mild hydronephrosis, both ovaries not visualised. Hysteroscopic examination showed obstruction due to imporforated hymen and narrowing at level of cervix and very thick mucoid secretion was found and drainage of about 100ml milky thick mucoid collection under USG guidance was done. 2DEcho was normal. According to these physical features, baby is likely to have McKusick-Kaufman syndrome.

Application of nanomagnetic bead-based DEHP detection and Doppler ultrasound in diagnosis of prenatal foetal malformations

Foetal malformations mainly refer to abnormal foetal structure and chromosomes in the womb. In recent years, with the popularisation and application of electronic products and the rise of the elderly maternal population, it has caused some impact on the quality of pregnant women's eugenics. However, foetal heart disease is not exactly the same as paediatric heart disease. The foetus is connected to the placenta through the umbilical cord. It has its own independent circulatory system and is inseparable from the mother. Although ultrasound technology has been introduced to the foetal heart examination for more than 40 years, and its equipment and diagnosis technology has made great progress and development in recent years, owing to the influence of various factors from the mother and foetus, the fine recognition of the foetal heart structure and the determination of various common or complex diseases need further improvement. In this paper, 1526 pregnant women who received antenatal ultrasound examination from January 2018 to May 2019 were selected as the research subjects. All were examined with colour Doppler ultrasound, and the results were analysed using autopsy and postnatal ultrasound examination results as criteria. The value of pre-colour ultrasonography, the results showed that 35 cases of foetal congenital malformations were detected by prenatal colour Doppler ultrasound, no misdiagnosis, five cases of complex congenital heart disease, 30 cases of common congenital heart disease, and common congenital heart disease Aortic translocation accounted for the highest proportion of sexual heart disease. The use of colour Doppler ultrasound for the diagnosis of foetal heart malformations can effectively detect the type of foetal heart malformations, which can provide a reliable basis for physicians to fully understand the foetal heart condition of pregnant women and follow-up symptomatic treatment, and improve the quality of newborn births.

Ultrasound diagnosis of fetal adrenal hemorrhage

The confirmed incidence of new-onset adrenal gland hemorrhage has increased with the development of ultrasound diagnostics in recent years. Intrauterine developed cases are rarely recognized. Differential diagnosis of cystic lesions of the adrenal gland is often only possible after birth. In our case study, we report the ultrasonographic diagnosis and follow-up of a cystic lesion measuring 4 × 3 cm in the left fetal epigastrium in the 33rd gestational week. During pregnancy, multimodal imaging methods (both ultrasound and magnetic resonance) have confirmed the diagnosis of hemorrhage in the left adrenal gland. In the 37th gestational week, the hematoma completely resolved. At term, a 4150 gram neonate was delivered in good condition by an elective cesarean section. Postnatal endocrinological and follow-up ultrasound examinations did not find any disorder. This study is the first published case report in the literature that proves that fetal adrenal hemorrhage can intrauterin spontaneously absorb within a short period of time. Our case draws attention to the fact that adrenal bleeding may occur in the newborn regardless of birth trauma. It can also be assumed that the incidence of adrenal bleeding during pregnancy is higher than that reported in neonatal cases. Orv Hetil. 2019; 160(52): 2073-2078.

Prenatal ultrasound diagnosis and clinical outcomes of fetal hepatohilar cystic occupying lesions

Objective To explore the prenatal ultrasound diagnosis and postnatal clinical outcomes of fetuses with hepatohilar cystic occupying lesions. Methods This was a retrospective study that included all fetuses found to have hepatohilar cystic occupying lesions diagnosed by ultrasound in the First Affiliated Hospital of Sun Yat-sen University between January 2008 and December 2017. According to the morphology of the cyst and max diameter, the cases were divided into four groups. Cases with polygonal cysts and max diameter over 30 mm were assigned to group 1, non-polygonal cysts and max diameter over 30 mm to group 2, polygonal cysts and max diameter under 30 mm to group 3, non-polygonal cysts and max diameter under 30 mm to group 4. The birth status, ultrasound review image, surgical treatment and pathological findings were tracked to analyze the prognosis of these fetuses. Results Among 47 cases of fetal hepatohilar cystic occupying lesions, 38 fetuses were born and 9 were terminated with only 1 case taking pathological examination. There were 39 cases with pregnancy outcomes. Twenty-seven cases (69.2%, 27/39) were diagnosed as congenital biliary dilatation (CBD), 5 cases (12.8%, 5/39) were found cysts resolved in postnatal ultrasound examinations. Biliary atresia was diagnosed in 3 cases (7.8%, 3/39) by operation; Mesenteric cysts (5.1%, 2/39) were diagnosed in 2 cases by ultrasound. One (2.6%, 1/39) was diagnosed as double-gallbladder by ultrasound. 1(2.6%, 1/39) was diagnosed as teratoma by operation. Most cases were in the group 3, but there was no significant difference compared with other groups (all P>0.05). Conclusions More than half of hepatohilar cystic occupying lesions diagnosed in prenatal ultrasound are proved to be CBD with good prognosis. The cysts in few cases can be resolved after born. 7.8% of cases are biliary atresia with poor prognosis, which give messages to prenatal clinical consultation. Key words: Ultrasonography; Fetus; Hepatohilar cystic occupying lesions; Congenital biliary dilatation; Biliary atresia; Prognosis

Right congenital diaphragmatic hernia – a diagnosis to consider

Objectives. Diaphragmatic hernia is not a common disease. The severity of symptoms may vary depending on the size of defect and the organs involved. A defect on the right side is quite rare. This congenital condition may not be clinically obvious for a long time. Material and method. We present the case of a patient hospitalized in the Pediatrics Department of “Grigore Alexandrescu” Hospital for unrelated pathology, incidentally diagnosed with right congenital diaphragmatic hernia after the age of three. Results (case presentation). 3 years 6 months old girl is admitted for persistent cough. An antenatal diagnosis of agenesis of the aortic arch had been set. She was born premature, required intensive care during the neonatal period, one diagnosis being right pulmonary hemorrhage. Postnatal ultrasound examination diagnosed venous duct anomaly. She had a good clinical course with normal growth, normal cardiac and liver functions. The clinical examination was unremarkable. A thoracic X-ray described homogeneous, well-defined opacity in the right lower pulmonary lobe. Abdominal ultrasound confirmed azygos continuation of the inferior vena cava. She underwent antibiotic therapy for pneumonia (7 days) with no change of the thoracic image. Thoracic computed tomography demonstrated Morgagni’s hernia with liver thoracic dislocation. Conclusions. Diaphragmatic hernia is a challenging diagnosis to be made. Although a congenital condition, it may be asymptomatic for a long time and a high degree of suspicion is required.

Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia.

To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. We included 8 neonates who underwent preoperative US evaluations of CDH. We compared anterior-to-posterior diaphragm defect sizes between thoracoscopic and open surgery approaches and between primary and patch repair by using the Mann-Whitney U test. The diaphragm was divided into 3 segments: anterior, lateral, and posterior. We evaluated the location of the diaphragmatic hernia and the hernial contents. Four neonates who underwent open surgery had larger diaphragmatic hernias than those who underwent thoracoscopic surgery (mean ± SD, 30.5 ± 5.6 versus 16.3 ± 3.3 mm; P = .030). They were also larger in neonates who underwent patch repair than in those who underwent primary repair (33.0 ± 3.0 versus 17.6 ± 4.2 mm; P = .037). Detection of anterior and lateral diaphragm segments was consistent between US and surgical findings. Three of 4 neonates who underwent open surgery and all 3 neonates who underwent patch repair did not show the lateral segment. The hernial contents were also consistent between US and surgical findings. Postnatal US examinations of neonates with CDH could provide surgeons with useful information to determine the surgical approach and repair method. However, since our study cohort was small, further studies are needed with a larger number of neonates with CDH.

What should be the criteria of renal pelvic dilatation in fetal anomaly screening?

Background: Different classification systems are used for diagnosing the renal pelvic dilatation in the fetus using imaging techniques in the antenatal period. The most commonly used parameter for the diagnosis of renal pelvic dilatation is the anteroposterior diameter (APD) of the renal pelvis in the transverse plane. Objectives: The objectives of this study are to compare the measurements of the renal pelvic dilatation in fetuses with the measurements reported in the literature together with their short-term follow-up resultsin the postnatal period. Materials and Methods: The infants were included in the study if they were consulted with the pediatric surgery clinic due to the diagnosis of renal pelvic dilatation detected by measuring the APD of the renal pelvis in the transverse plane during an ultrasound examination when their mothers were screened for detecting fetal anomalies between July 2017 and February 2018 at the perinatology clinic. Results: The postnatal ultrasound examination, conducted for monitoring purposes, revealed that 82.7% (n=57) of the infants diagnosed with a dilatation of the renal pelvis had regression or resolution of the renal pelvic dilatation;however, it was observed that it persisted in the postnatal period in 17.3% (n=12) of the patients. The classification of the renal pelvic dilatation in 47 fetuses diagnosed during the screening for fetal anomalies in the second trimester of pregnancy showed that 41 (87.2%) of them were classified as mild, 5 (7.2%) of them were classified as moderate, and 1 (1.4%) of them was classified as severe. Conclusion: Based on the findings of measurements performed in the pregnant women screened at our hospital, this study reported the measurements of the renal pelvic dilatation in fetuses and compared the results reported in the literature together with their short-term follow-up results in the postnatal period.

A case of atypical multicystic dysplastic kidney in the fetus

This article describes a case of the dynamic ultrasound examination of multicystic dysplasia of the fetal left kidney from 20 weeks of gestation until the birth. The huge enlargement of one of the cysts with an abdominal compression was revealed at 24–25 weeks of gestation. The aspiration of the contents of the cyst was performed triples. The cyst regression was marked at 36–37 weeks of gestation. The postnatal ultrasound examination confirmed the multicystic dysplasia of the left kidney.

Isolated low grade prenatally detected unilateral hydronephrosis: do we need long term follow-up?

ABSTRACTPurpose:To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis.Materials and Methods:We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented.Results:A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention.Conclusions:Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.

Severe tortuous intra-abdominal segment of isolated single umbilical artery by three-dimensional high-definition flow imaging

The authors report a tortuous intra-abdominal segment of isolated single umbilical artery (SUA) that proved to be an omega-shaped variant by three-dimensional high-definition-flow (3D-HD-flow) imaging. A 28-year-old woman was referred to the present center for detailed fetal echocardiography examination after finding SUA during routine two-dimensional ultrasound examination at 24+3 weeks’ gestation. 3D-HD-flow demonstrated a severely tortuous and dilated intra-abdominal segment of SUA mimicking omega-shaped variant. Postnatal abdominal ultrasound and cardiac examination were unremarkable. This case suggests that the omega-shaped variant of SUA is probably a normal variant when unassociated with other structural anomalies. When a locally dilated umbilical artery is detected during routine 2D ultrasound, the authors recommend using 3D color Doppler imaging to more precisely determine the course of the umbilical artery.

Classification of pediatric urinary tract dilation: the new language.

The multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system) was created to unify the language used to describe urinary tract dilation on antenatal and postnatal ultrasound examinations and thereby facilitate communication among providers and improve outcomes research. The background and new classification system are described in this review, with imaging examples.

Genetic spectrum of Saudi Arabian patients with antenatal cystic kidney disease and ciliopathy phenotypes using a targeted renal gene panel

BackgroundInherited cystic kidney disorders are a common cause of end-stage renal disease. Over 50 ciliopathy genes, which encode proteins that influence the structure and function of the primary cilia, are...

Renal failure due to renal vein thrombosis in a fetus with growth restriction and thrombophilia

We report a case of renal vein thrombosis diagnosed at 27 weeks of gestation in a dichorionic twin pregnancy. The left kidney of one fetus was hyperechoic and enlarged with echoic streaks following the direction of interlobular veins and the loss of corticomedullary differentiation. In the following weeks, left kidney became smaller and echoic, and Doppler examination showed no flow in both artery and vein. The right kidney had totally normal appearance in the beginning, but it became enlarged and hyperechoic, and progressed into a small echoic kidney with no flow in artery and vein. In the postnatal ultrasound examination, both kidneys appeared hyperechoic with no vascularization in the hilum region. There was thrombosis in arteries and veins of both kidneys, as well as in the inferior vena cava. The investigation for thrombophilia resulted with the combined presence of heterozygote mutation in factor V Leiden and prothrombin 20210 genes.

English

OBJECTIVES: Purpose of our study was to determine the detection rate of congenital anomalies in second trimester by single prenatal ultrasound screening in an unselected population and to evaluate the subsequent pregnancy outcome and to compare the results with published series using standardized criteria. SUBJECTS AND METHODS - One thousand pregnant women at 18-22 weeks' gestation were screened by prenatal ultrasound examination. We compared these sonographic reports with pregnancy outcomes established by postnatal echocardiography and ultrasound examinations of neonates and autopsy for dead fetuses. Statistical analysis was performed on two units; malformed fetus and malformation itself. RESULTS - A total of 27 fetuses with 30 anomalies were identified by prenatal ultrasound. Prospectively 2 babies with 2 anomalies were found to be normal. On postnatal examination 13 babies were found to have 14 anomalies which could not be detected by ultrasound. Thus the sensitivity of ultrasound in detecting congenital anomalies and anomalous fetuses was 66.6% and 67.5% respectively. Highest detection rate was observed for CNS anomalies (88.8%) but that of craniofacial and musculoskeletal anomalies was not very satisfactory (33% in each system). CONCLUSION -This study shows rate of detection of fetal anomalies is satisfactory for most organ systems except cardiac, musculoskeletal and craniofacial malformations.

Ultrasound Screening Strategies for the Diagnosis of Congenital Anomalies of the Kidney and Urinary Tract

Congenital anomalies of the kidneys and urinary tract (CAKUT) are among the most common anomalies in newborn infants, and may cause chronic renal disease in newborns. We investigated the sensitivity and specificity of different ultrasound-based screening strategies for CAKUT. Newborns (n = 4331) were analyzed for CAKUT in at least one ultrasound examination as a part of the Survey of Neonates in Pomerania (SNiP), a 7-year population-based study on neonates in Western Pomerania (Germany). Intrauterine ultrasound examinations were compared with early postnatal ultrasound findings (from days 3 - 7 of life) and pathological findings within the first 6 months of postnatal life. Cases of CAKUT were detected in 309 (3.7 %) kidneys in one ultrasound examination at the following points of time at least: (i) prenatally in 56 newborns (18.2 %), (ii) 3 - 7 days postnatally in 201 newborns (65.2 %) and (iii) in 52 newborns (17 %) during the 6-month follow-up. The prevalence was significantly higher in male infants, and hydronephrosis was found to be the most frequent obstructive nephropathy (83.3 %). Significant co-morbidity was observed with CNS malformations. The diagnostic sensitivity was significantly higher in postnatal ultrasound screening (79.6 vs. 18.2 % prenatally), while the specificity was above 99 % at all time points. This study demonstrates a high prevalence of CAKUT and demonstrates the importance of combined prenatal and postnatal ultrasound examinations for early CAKUT diagnosis.

Early renal abnormalities in children with postnatally diagnosed autosomal dominant polycystic kidney disease

Autosomal dominant polycystic kidney disease (ADPKD) in children is often regarded as a benign condition. However, previous studies pointed out renal-related anomalies which may benefit from early appropriate treatments. This study was conducted to evaluate the prevalence and severity of early renal dysfunction in ADPKD children. An extensive renal evaluation was performed in 52 consecutive ADPKD patients diagnosed either from prenatal screening or post-natal ultrasound (US) examination (54 % males, mean age 10 ± 4 years [1-17]). Three patients had both systolic (SBP) and diastolic (DBP) blood pressure above the 95th percentile, one patient had a "high normal" DBP, and one child was treated with an angiotensin-converting enzyme inhibitor (ACEI). The mean ± SD glomerular filtration rate (GFR ml/min per 1.73 m(2), inulin clearance) was 115 ± 26 [47-168] but six children (12 %) had a GFR < 90 and 11 (21 %) experienced hyperfiltration (GFR > 135). Microalbuminuria (2 < Ualb/Ucr ≤ 20 mg/mmol) was found in 25 patients and five had macroalbuminuria (>20 mg/mmol). Early renal manifestations are frequent in ADPKD children, including hypertension in 6 %, albuminuria in 58 %, and decreased GFR in 12 %. In conclusion, renal function in children with ADPKD should be regularly assessed in order to manage early renal dysfunction and even consider further therapeutic intervention.