Üriner Sistem Anomalisi Saptanan Fetuslara Yaklaşım

Aim: The aim of this prospective study was to demonstrate the management of the cases diagnosed as fetal urinary malformation at antenatal period and to compare findings to their neonatal findings. Material and Methods: This study included 57 cases who were diagnosed with antenatal ultrasound at Ministry of Health Aegean Obstetrics and Gynecology Teaching Hospital between January 2004 and January 2005. Cases were divided into group 1( with no functional kidney), group 2 (with at least one functional kidney), group 3 (with pyelectasia). Pyelectasia was described as anterior posterior diameter of renal pelvis to ≥5mm. Renal pelvis diameter was evaluated before and after 30 gestational week in respect to progression of pyelectasia. The data of cases who had urinary system anomalies diagnosed at postpartum period were collected retrospectively from hospital records. Results: Three of group 1’cases were aborted. Other 5 fetus died after partution. One case in group 2 was operated after partution. Urinary system abnormality was seen in 15 of 48 cases (Group 3) at neonatal period. Four of them were operated. 28 cases with pyelectasia got antibiotic threapy due to urinar tract infection. Three cases underwent amniocentesis and one of them was terminated due to Down Syndrome. Chromosomal inversion was determined in other one. 8 of 57 cases (14%) had anhydramnios and 4 of them (7%) had polyhydramnios. Conclusion: Prenatal diagnosis of urinary system anomalies is so important for termination of pregnancy, consideration of amniocentesis for ongoing and planning neonatal follow up. The moderate pyelectasia due to organic lesion should be counselled to pediatric urology specialist for preventing kindney loss.