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Titolo:
PRENATAL INTERVENTION FOR HYDRONEPHROSIS
Autore:
COPLEN DE;
Indirizzi:
WASHINGTON UNIV,ST LOUIS CHILDRENS HOSP,SCH MED,DIV UROL ST LOUIS MO 63110
Titolo Testata:
The Journal of urology
fascicolo: 6, volume: 157, anno: 1997,
pagine: 2270 - 2277
SICI:
0022-5347(1997)157:6<2270:PIFH>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTERIOR URETHRAL VALVES; FETAL OBSTRUCTIVE UROPATHY; URINARY-TRACT ABNORMALITIES; BLADDER OUTLET OBSTRUCTION; CONGENITAL HYDRONEPHROSIS; RENAL DYSPLASIA; ANTENATAL ULTRASONOGRAPHY; SEVERE OLIGOHYDRAMNIOS; PULMONARY HYPOPLASIA; DETECTED INUTERO;
Keywords:
HYDRONEPHROSIS; KIDNEY; PRENATAL DIAGNOSIS; ULTRASONOGRAPHY, PRENATAL;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
63
Recensione:
Indirizzi per estratti:
Citazione:
D.E. Coplen, "PRENATAL INTERVENTION FOR HYDRONEPHROSIS", The Journal of urology, 157(6), 1997, pp. 2270-2277

Abstract

Purpose: The widespread use of prenatal ultrasound results in an increased recognition of fetal hydronephrosis and technological advances now make fetal intervention possible. However, efficacy is unknown, andthere have been errors in diagnosis, and associated morbidity and mortality. This review focuses on the current status of prenatal diagnosis and management of hydronephrosis. Materials and Methods: The relevant literature on prenatal physiology, prenatal diagnosis, experimental obstruction and clinical series of prenatal intervention was reviewed. Results: Prenatal ultrasound is a poor discriminator of physiologicalhydronephrosis, obstruction, renal dysplasia and reflux. Persistent early onset oligohydramnios is the best predictor of poor neonatal outcome. New minimally invasive techniques may aid diagnostically but theymay not improve outcome. Dysplasia is often present by the time hydronephrosis is detected and it is not reversible in experimental models. Prenatal intervention is technically feasible but the survival rate is only 47%, and catheter placement and open fetal surgery have significant fetal and maternal risks. Complications occur in up to 45% of fetuses. Conclusions: Prenatal intervention for hydronephrosis remains anexperimental technique. The most important question is whether prenatal therapy for obstructive uropathy improves survival and decreases long-term morbidity and mortality in affected fetuses.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 08:25:08