Is omitting post urinary-tract-infection renal ultrasound safe after normal antenatal ultrasound? - an observational study

Dan Miron ^1*, Ahmed Daas ¹, Waheeb Sakran ¹, Ariel Koren ¹ and Yoseph Horovitz ¹

¹ HaEmek Medical Center, Afula, Israel

^* To whom correspondence should be addressed. E-mail: miron_da{at}clalit.org.il.

Accepted 24 December 2006

Abstract

Background: Guidelines recommend obtaining renal ultrasonogram (RUS) for young children after a first urinary tract infection (UTI).

Objective: The aim of the current study was to assess the concordance of prenatal and post-UTI RUS findings in children with first simple UTI.

Methods: The present study was prospective and included were all children age 5 years or younger who were hospitalized with first simple UTI (determined as clinical response, and normalization of temperature within 48 hours on initiation of antibacterial therapy, with no complications). Data were collected from each child regarding results of prenatal and post-UTI RUS.

Results: Overall, 250 children were included in the study for whom 84% (n= 209) results of late- pregnancy and post-UTI RUS were available. Complete concordance between the two RUS was demonstrated in 96% (n=201). The predictive value of normal antenatal RUS to normal post-UTI test was 96% (CI 95%, 93%-99%). These results include 4 children with mild transient pelvic dilatation. In 8 children in whom renal anomalies were demonstrated only in post-UTI RUS, their influence on children's management was negligible.

Conclusions: In children hospitalized with first simple UTI, prenatal-RUS was performed in most. Concordance with post-infection tests is very high. Findings which appear only in post infectious RUS usually have negligible effect on children's management.

Keywords: child, pregnancy, renal ultrasonogram, urinary tract infection, vesicourethral reflux

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