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The outcome of antenatal ultrasound diagnosed anomalies of the kidney and urinary tract in a large Danish birth cohort
  1. Liv Andrés-Jensen1,
  2. Finn Stener Jørgensen2,3,
  3. Jorgen Thorup3,4,
  4. Julie Flachs1,
  5. Jan Lysgaard Madsen5,
  6. Lisa Leth Maroun6,
  7. Pernille Nørgaard2,
  8. Pablo Gustavo Vinicoff7,
  9. Beth Härstedt Olsen7,
  10. Dina Cortes1,3
  1. 1Department of Paediatrics, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
  2. 2Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
  3. 3Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
  4. 4Department of Paediatric Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
  5. 5Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
  6. 6Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
  7. 7Department of Radiology and Ultrasound, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
  1. Correspondence to Professor Dina Cortes, Department of Paediatrics, Copenhagen University Hospital Hvidovre, Kettegaard Alle 16, Hvidovre 2650, Denmark; Dina.cortes{at}regionh.dk

Abstract

Objective Antenatal ultrasound diagnosed anomalies of the kidney and urinary tract (AUDAKUT) are reported in 0.3%–5% on prenatal ultrasound (US) and 0.3%–4.5% on postnatal US. The anterior-posterior diameter of the renal pelvis (APD) is an essential measurement. Series with low threshold values of APD prenatally and postnatally will include healthy infants. It is important to avoid follow-up of such infants.

Interventions In 2006, new Danish guidelines for AUDAKUT were introduced.

Aim of study Investigations of incidences and type of AUDAKUT based on Danish guidelines, including long-term follow-up.

Design Cohort study.

Setting Copenhagen University Hospital Hvidovre and Copenhagen University Hospital Rigshospitalet, Denmark.

Patients Consecutive cases with AUDAKUT in the second and third trimesters, which were either terminated before 22 completed weeks of gestation or born in the 8-year period January 2006–December 2013. Patients were followed until June 2014.

Results 50 193 live born children and 24 terminated fetuses (0.05%) were included. The prevalence of AUDAKUT was only 0.39% prenatally, 0.29% at first postnatal US and 0.22% at the end of follow-up, including terminated cases. The greater the prenatal and postnatal APD, the higher risk of febrile urinary tract infection (fUTI) and surgical intervention, and lower probability of resolution. 25% of the identified patients had fUTI and/or surgery.

Conclusions We recommend threshold values of APD at least 10 mm in the third trimester and in general at least 12 mm at first postnatal US for intensive follow-up. In this largest to date unselected birth cohort of AUDAKUT, the incidences of clinically significant AUDAKUT were in the lowest range of those previously published.

  • Congenital Abnorm
  • Fetal Medicine
  • Paediatric Practice
  • Nephrology
  • Paediatric Surgery

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