Renal Anteroposterior Diameter Research Articles

Relationship between estimated foetal weight and maternal renal volume in normal pregnant women in Bayelsa state, South-South Nigeria

Background: The weight of the foetus is an important factor to consider when determining the outcome of pregnancy. The birth weight is reliable in predicting perinatal outcome. Excessive and low weights of the baby are associated with increased risk of newborn complications during labour, delivery and postpartum. The objective of the study was to determine the relationship between estimated foetal weight and maternal renal dimensions and volume in normal pregnant women in Bayelsa State, Nigeria.Methods: This prospective, descriptive, cross-sectional study was conducted at the Obstetrics and Gynaecology, and Radiology Departments of the two tertiary hospitals in Bayelsa State, Nigeria, from July to December, 2021. Sonographic assessments of estimated foetal weight and the maternal renal dimensions and volume in 400 consecutive normal pregnant women in both tertiary institutions were done, after obtaining written informed consent from them. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions for windows® version 25, (SPSS Inc.; Chicago, USA). Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.Results: A total of 400 pregnant women were scanned. There was a valid relationship between right renal antero-posterior diameter (ɼ = 0.32; p – 0.010), right renal width (ɼ = 0.32; p – 0.007), right renal volume (ɼ = 0.32; p – 0.007) and estimated foetal weight. The left renal width and renal volume showed the same trend as the right parameters with slight differences in values.Conclusions: This study revealed that estimated foetal weight increased with increase in maternal renal volume and dimensions.

Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women.

The aim of this study is to determine the proportion of maternal hydronephrosis and symptomatic cases requiring treatment in pregnant women without ureteral stones and the characteristics of these cases. Between February 2018 and April 2019, all pregnant women followed for pregnancy in obstetrics and outpatient policlinic were evaluated prospectively. Maternal hydronephrosis rate, degree of hydronephrosis and side, symptomatic hydronephrosis rate, maximum renal anteroposterior diameter of renal pelvis and visual analogue scale were detected. Symptomatic patients were treated conservatively or surgically. Findings in both treatment groups were analyzed by t-test or Chi-squared test. Pearson or Spermean's tests were used for correlation analyzes. A total of 1026 pregnant women aged 18-45 (27.7 ± 5.2 years) were followed prospectively. The rate of maternal hydronephrosis was 28.7% and the rate of symptomatic hydronephrosis was 4.7%. Of the patients with symptomatic hydronephrosis, 73.4% (3.5% of total) were treated conservatively and 26.5% (1.3% of total) were treated surgically. There was a positive correlation between hydronephrosis and gestational week (p < 0.001), visual analogue scale (p < 0.001) and hematuria (p < 0.05). There was a negative correlation between hydronephrosis and maternal age (p < 0.05) and number of pregnancies (p < 0,001). The anteroposterior diameter of renal pelvis (p < 0.001), visual analogue scale (p < 0.05) and fetal body weight values (p < 0.05) on the right side were higher in the surgical treatment group than the conservative group. The majority of cases with maternal hydronephrosis in pregnant women without ureteral stones are asymptomatic. Most symptomatic cases can also be treated conservatively. In cases requiring surgical treatment (1.3%), fetal body weight, visual analogue scale and anteroposterior renal pelvis diameter are higher.

Sonographic Renal Dimension in Patients with Essential Hypertension in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria

Introduction: Hypertension is one of the commonest non-communicable diseases worldwide; it is the second most common cause of end-stage renal disease. Objective: To evaluate the renal dimensions and volume of essential hypertension patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi and to compare the dimensions with that of apparently healthy volunteers. Materials and Methods: A total of two hundred and eleven individuals (comprising 121 females and 90 males) with essential hypertension attending an outpatient clinic in Abubakar Tafawa Balewa University Teaching Hospital Bauchi, and an equal number of healthy volunteers (comprising of 172 females and 49 males) were studied as controls. Both the healthy volunteers and the Hypertensive patients’ renal length, renal width, antero-posterior diameter, and parenchymal thickness were assessed. Statistical Package for Social Sciences (SPSS version 20.0) was used for data analysis. Results: Study show the mean renal length for hypertensive patients to be 9.1 ± 0.79 cm and 9.1 ± 0.73 cm, the mean renal width of 3.5 ± 0.48 cm and 3.8 ± 0.68 cm, and mean renal volume of 87.22 ± 19.58 cm3 and 95.08 ± 22.93 cm3 for the right and left kidneys respectively. Results equally show statistically significant difference in anteroposterior diameter (p&amp;lt;0.05), parenchymal thickness (p&amp;lt;0.05) and renal volume (p&amp;lt;0.05) between the hypertensive group and the volunteer group for both right and left kidneys. Conclusion: This study has established baseline renal dimensions for hypertensive in our population (Bauchi Metropolis). The hypertensive subjects showed a decrease in renal anteroposterior diameter, parenchymal thickness and volume compared to control group.

Fetal Hydronephrosis as a Predictor of Neonatal Urologic Outcomes

The ability to predict surgically relevant fetal renal hydronephrosis is limited. We sought to determine the most efficacious second- and third-trimester fetal renal pelvis anteroposterior diameter cutoffs to predict the need for postnatal surgery. We retrospectively reviewed the medical records of mothers and neonates who had a prenatal sonographic examination in our Perinatal-Pediatric Urology Clinic and received follow-up care. Hydronephrosis was defined as a renal pelvis anteroposterior diameter of 5 mm or greater in the second trimester and 7 mm or greater in the third trimester. Hydronephrosis was subdivided into mild, moderate, and severe. Of 8453 fetuses, 96 met the criteria and were referred to our clinic. Isolated hydronephrosis was diagnosed in 74 fetuses, of which 53 received postnatal follow-up evaluations. The areas under the receiver operating characteristic curves for predicting postnatal surgery in the second and third trimesters were 0.770 and 0.899, respectively. The second-trimester renal anteroposterior diameter threshold that best predicted post-natal surgery was 9.5 mm (sensitivity, 71.4%; specificity, 81.1%). The third-trimester threshold that best predicted postnatal surgery was 15.0 mm (sensitivity, 85.7%; specificity, 94.6%). The fetal renal anteroposterior diameter on second- and third-trimester sonography is predictive of an increased risk for neonatal urologic surgery. Surgical risk is best predicted by a third-trimester renal anteroposterior diameter threshold of 15 mm.

Postnatal Follow-Up of Hydronephrosis Detected by Prenatal Ultrasound: The Natural History

Babies with hydronephrosis detected antenatally who were born at or referred to our hospital from 1990 to 1995 were followed up with ultrasound (U/S), micturating cystourethrogram (MCU) or nuclear medicine studies after birth. One hundred and three patients were diagnosed antenatally at 17–42 weeks gestation. Twelve cases were excluded from the analysis of the results because of incomplete data. Fifty-one (56%) patients had hydronephrosis without organic obstruction, and 80% of these became normal in 3 years. Fifteen patients (17%) had a normal scan 4 days after birth. This suggests the possibility of antenatal spontaneous regression. Seven (8%) had a ureterocele and 4 (5%) had pelviureteric junction (PUJ) obstruction. Four (5%) had vesicoureteric reflux, and 4 (5%) had primary megaureter. Two (2%) had posterior urethral valves (PUV), 3 (3%) had refluxing primary megaureter, and 1 (1%) had urethral atresia. Fifteen patients (17%) underwent surgical intervention. Six had a nephrectomy, 1 a vesicostomy, 3 an Anderson-Hynes pyeloplasty, 3 had the ureterocele unroofed, 1 had a ureteric reimplant, and 1 ablation of valves. In 42 infants with 60 abnormal kidneys, the renal anteroposterior diameter of the pelvis was measured. Retrospectively, 48 kidneys diagnosed as having hydronephrosis, antenatally had a renal pelvis diameter ≥4 mm before 33 weeks gestation or ≥7 mm after 33 weeks gestation. One patient with PUJ obstruction lost kidney function, but there is no good marker to detect these patients. Early unroofing of ureteroceles may rescue kidney function. Our follow-up protocol for antenatal hydronephrosis is U/S at 4 days, 1 month and 1 year of age. An MCU is not required unless the ureter is seen on antenatal U/S. If dilatation persists past 1 month, a radionucleotide (MAG3) scan and repeat U/S are performed at 3 months. The methods for assessing obstruction and the indications for surgical intervention in these patients require reexamination.