The prevalence of fetal hydronephrosis in children with vesicoureteral reflux and the relationship of their severities

Abstract

In recent years, modern methods have been introduced for early diagnosis of diseases. Ultrasound studies during pregnancy can distinguish intrauterine abnormalities; indeed, most fetal anomalies have become detectable by routine fetal ultrasonography. More popular use of prenatal ultrasound has incresed the number of reported cases of fetal anomalies. A fetal structural abnormality is detected in about 1% of pregnancies by ultrasound, with genitourinary malformations accounting for about 20 to 50 percent of these abnormalities. Due to the lack of precise correlation between fetal hydronephrosis and the incidence of vesicouvertral reflux in infancy; in the present study, the prevalence of fetal hydronephrosis has been surveyed in children who had vesicouvertral reflux in our region; besides, the relationship between their severities has been asessed for the first time. It is hoped that the results of this study can help us to prevent serious kidney damage in childhood. Materials and Methods: In this study, children who are referred to the radiology department of Tabriz Children's Educational and Medical Center for VCUG in the first six months of 2019 and were diagnosed as having VUR, patients' information was recorded after obtaining informed-written consent from their parents, and enrolled into the study (Inclusion Criteria). Ultrasonographic study of these children during second trimester of their fetal life was also reviewed for the presence of a history for fetal hydronephrosis and its severity. In cases whose renal-pelvis AP-diameter in fetal period was greater than 5 mm, mild and if more than 7 mm, moderate hydronephrosis was diagnosed. If fetal hydronephrosis was accompanied by dilation of the calyces was considered as severe; and if the fetus had an anterior-posterior pelvic diameter greater than 10 mm in the third trimester, Persistent hydronephrosis was determined. Then, the prevalence of fetal hydronephrosis among patients with VUR and the correlation between their severities and sex were compared by statistical methods. Results: In this study, 40 children were studied (20 males and 20 females), with the mean age of 3.78 ± 3.12 years. About two thirds (67.5%) of children with VUR did not have previous fetal hydronephrosis as the prevalence of hydronephrosis in these children was reported as 32.5%. According to the results, male gender has a significant correlation with the prevalence of fetal hydronephrosis in children with VUR as the prevalence of hydronephrosis in boys is significantly higher than girls. Also, the severity of hydronephrosis is not related to gender. Conclusion: