A fetopathológiai vizsgálat szerepe a húgyúti rendszer rendellenességeinek klinikai megítélé sében

Translated title of the contribution: Role of fetopathological investigations in the clinical assessment of urinary tract malformations

József Gábor Joó, A. Beke, Zsanett Szigeti, Ákos Csaba, Gábor Mezei, E. Tóth-Pál, Attila Rab, Z. Papp, C. Papp

Research output: Contribution to journalArticle

Abstract

Malformations of the kidney and the urinary system are among the most common disorders. As the prognosis of the urinary tract malformations is rather different - sometimes very poor -, it is of great importance to examine the main clinical, genetic and pathological characteristics of them. Surveying the major clinical features of the kidney and urinary passages as well as the efficacy of ultrasonographic diagnostics based on fetopathological investigations both help with the profound familiarisation with the disorders of this system. In the current publication, we have processed the details of 120 pregnancies terminated by induced abortions owing to a presumed or justified urinary tract malformation in the period of 1995-2006. In three quarters of the cases (90 patients), the induced abortions were indicated due to the partial or full absence of amniotic fluid, while in 30 cases (25%) specific urinary tract malformations served as the ground for abortions. Among the 90 pregnancies complicated by oligo/anhydramnion, it was actually a urinary tract malformation that stood in the background of partial or complete absence of amniotic fluid in 38 pregnancies (42.2%), thus the number of real urinary tract malformations amounted to 68. The maternal median age was 27± 5.37 years. In 17.6% (12 cases) of real urinary tract malformations among the 68 cases the history was positive; in 11 cases of them (16.2%) positive obstetric history, while in one case the recurrence of renal agenesis was found to cause the problem. The 1.83 boy to girl ratio showed the higher involvement of male fetuses. In 76.5% of the cases (52 patients), prenatal ultrasonography and fetopathological investigations were unanimous in their result. In 5 cases (7.4%) there was partial agreement between the results in these two kinds of investigations; certain supplements were added to the sonographic findings on the basis of post mortem investgations. In 11 cases (16.1%), autopsy resulted in a new diagnosis. Since urinary tract malformations are often accompanied by the partial or complete absence of the amniotic fluid, and owing to the difficulties in diagnosing such pregnancies, their sonographic investigation and follow up are strongly recommended in highly specialized genetic centres. Among such investigations special attention and experience are required in performing sonography to detect the cystic changes in fetal kidneys. Cardiovascular malformations, which are relatively often associated with urinary tract malformations - especially renal failure due to cystic degeneration - may make it necessary to perform fetal echocardiography in such cases.

Original languageHungarian
Pages (from-to)355-362
Number of pages8
JournalMagyar Noorvosok Lapja
Volume70
Issue number6
Publication statusPublished - 2007

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Urinary Tract
Amniotic Fluid
Pregnancy
Induced Abortion
Kidney
History
Prenatal Ultrasonography
Maternal Age
Obstetrics
Renal Insufficiency
Echocardiography
Autopsy
Ultrasonography
Fetus
Recurrence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

A fetopathológiai vizsgálat szerepe a húgyúti rendszer rendellenességeinek klinikai megítélé sében. / Joó, József Gábor; Beke, A.; Szigeti, Zsanett; Csaba, Ákos; Mezei, Gábor; Tóth-Pál, E.; Rab, Attila; Papp, Z.; Papp, C.

In: Magyar Noorvosok Lapja, Vol. 70, No. 6, 2007, p. 355-362.

Research output: Contribution to journalArticle

Joó, József Gábor ; Beke, A. ; Szigeti, Zsanett ; Csaba, Ákos ; Mezei, Gábor ; Tóth-Pál, E. ; Rab, Attila ; Papp, Z. ; Papp, C. / A fetopathológiai vizsgálat szerepe a húgyúti rendszer rendellenességeinek klinikai megítélé sében. In: Magyar Noorvosok Lapja. 2007 ; Vol. 70, No. 6. pp. 355-362.
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abstract = "Malformations of the kidney and the urinary system are among the most common disorders. As the prognosis of the urinary tract malformations is rather different - sometimes very poor -, it is of great importance to examine the main clinical, genetic and pathological characteristics of them. Surveying the major clinical features of the kidney and urinary passages as well as the efficacy of ultrasonographic diagnostics based on fetopathological investigations both help with the profound familiarisation with the disorders of this system. In the current publication, we have processed the details of 120 pregnancies terminated by induced abortions owing to a presumed or justified urinary tract malformation in the period of 1995-2006. In three quarters of the cases (90 patients), the induced abortions were indicated due to the partial or full absence of amniotic fluid, while in 30 cases (25{\%}) specific urinary tract malformations served as the ground for abortions. Among the 90 pregnancies complicated by oligo/anhydramnion, it was actually a urinary tract malformation that stood in the background of partial or complete absence of amniotic fluid in 38 pregnancies (42.2{\%}), thus the number of real urinary tract malformations amounted to 68. The maternal median age was 27± 5.37 years. In 17.6{\%} (12 cases) of real urinary tract malformations among the 68 cases the history was positive; in 11 cases of them (16.2{\%}) positive obstetric history, while in one case the recurrence of renal agenesis was found to cause the problem. The 1.83 boy to girl ratio showed the higher involvement of male fetuses. In 76.5{\%} of the cases (52 patients), prenatal ultrasonography and fetopathological investigations were unanimous in their result. In 5 cases (7.4{\%}) there was partial agreement between the results in these two kinds of investigations; certain supplements were added to the sonographic findings on the basis of post mortem investgations. In 11 cases (16.1{\%}), autopsy resulted in a new diagnosis. Since urinary tract malformations are often accompanied by the partial or complete absence of the amniotic fluid, and owing to the difficulties in diagnosing such pregnancies, their sonographic investigation and follow up are strongly recommended in highly specialized genetic centres. Among such investigations special attention and experience are required in performing sonography to detect the cystic changes in fetal kidneys. Cardiovascular malformations, which are relatively often associated with urinary tract malformations - especially renal failure due to cystic degeneration - may make it necessary to perform fetal echocardiography in such cases.",
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AU - Beke, A.

AU - Szigeti, Zsanett

AU - Csaba, Ákos

AU - Mezei, Gábor

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AU - Rab, Attila

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AU - Papp, C.

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KW - Efficacy of sonography

KW - Fetopathological examination

KW - Oligohydramnion

KW - Polycystic kidney

KW - Renal agenesis

KW - Urinary tract malformations

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