Abstract

DURAN ALVAREZ, Sandalio; CALVIAC MENDOZA, Rosario; DURAN MENENDEZ, Raisa  and  MARRERO GARCIA, Yamilé. Prenatal hydronephrosis in double excretory system. Rev Cubana Pediatr [online]. 2007, vol.79, n.4. ISSN 0034-7531.

With the introduction of the maternofetal ultrasound in the systematic follow-up of  normal pregnancy, congenital anomalies are detected in 1 % of the fetuses, 20 % of which correspond to the urinary tract. The  newborns and  infants with prenatal hydronephrosis were studied. The maternofetal ultrasound showed a double excretory system. To this end, all the newborns and infants with prenatally detected hydronephrosis and double excretory system diagnosed before or after  birth were followed up by evolutive renal ultrasonography, micturition urethrocystography, static or dynamic scintigraphy and, in some cases, by excretory urogram. Double excretory system was found  in 7 of the 182 patients (3.8 %) with abnormalities of the urinary tract diagnosed before birth. Diagnosis was prenatal in just one of the fetuses (31 weeks of pregnancy). Hydronephrotic dilatation was mild in two fetuses and severe in five. Hydronephrosis had different causes. Upper polar  nephrectomy was performed  in those cases of ureteral  ectopy and obstructed upper ureter, reimplantation in one ureterocele, whereas in another it was confirmed the spontaneous rupture by endoscopy. The rest of the patients were symptomatically treated. The hydronephrosis detected before birth by maternofetal ultrasonography may be associated with a double excretory system. Hydronephrotic dilatation associated with a double excretory system may have different causes, and it is necessary to study carefully and systematically these children and to treat them adequately, since each of them may need a different conduct.

Keywords : Prenatal hydronephrosis; double excretory system; ureterocele; ectopic ureter; vesicoureteral reflux.

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