先天性肾脏和泌尿系统异常的产前诊断和产后结局:一项单中心回顾性研究

Gokce Annac
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摘要

目的:探讨先天性肾尿路异常(CAKUT)的产前超声表现、患病率、预后因素及产后结局。方法:对2015年1月至2022年1月期间妊娠18-40周的孕妇电子健康记录进行单中心回顾性研究。在子宫内被诊断为患有CAKUT并在产前和产后随访的婴儿都参加了这项研究。结果:15460例胎儿中,有417例胎儿发生CAKUT,发生率为2.6%。最常见的CAKUT是肾积水/骨盆扩张(n=476, 2.1%)。大约67%的CAKUT病例表现出正常化或回归。四分之一的CAKUT患儿接受了手术治疗[75%的羊水过少,20%的肾积水/骨盆扩张,14%的巨囊炎,37%的多囊发育不良肾病(MCDK)]。CAKUT患儿染色体异常发生率为1.2%。11例(2.7%)CAKUT患儿在围产期死亡。所有患有双侧肾发育不全和双侧MCDK的婴儿都导致了流产。结论:CAKUT是一种非常常见的异常,患病率为2.6%。在我们的研究中,大多数的CAKUT表现为自发消退,25%的患儿需要手术治疗。羊水过少和双侧异常是不良结局的危险因素。
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Prenatal diagnosis and postnatal outcome of congenital anomalies of the kidney and urinary tract system: A single-center retrospective study
Aim: To evaluate the prenatal sonographic findings, prevalence, prognostic factors and postnatal outcome of congenital anomalies of the kidney and urinary tract (CAKUT).Method: This single-center retrospective study was conducted from electronic health records of pregnant women between 18-40 weeks of gestation from January 2015 to January 2022. Babies who were diagnosed as having CAKUT in utero and followed prenatally and postnatally were enrolled in the study.Results: Out of 15,460 fetuses, 417 fetuses had CAKUT with a frequency of 2.6%. The most common CAKUT was hydronephrosis/pelvis dilatation (n=476, 2.1%). Approximately 67% of CAKUT cases showed normalization or regression. A quarter of babies with CAKUT underwent surgery [75% of oligohydramnios cases, 20% of hydronephrosis/pelvis dilatation cases, 14% of megacystis cases, and 37% of multicystic dysplastic kidney disease (MCDK) cases]. The chromosomal anomaly incidence in babies with CAKUT was 1.2%. Eleven (2.7%) babies with CAKUT died in the perinatal period. All babies with bilateral renal agenesis and bilateral MCDK resulted in exitus. Conclusion: CAKUT is a very common anomaly with a prevalence of 2.6%. Most of the CAKUT in our series showed spontaneous regression, and 25% of affected babies needed surgery. Oligohydramnios and bilateral anomalies were risk factors for adverse outcomes.
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