Antenatal hidronefroz tanısı alan çocukların postnatal değerlendirilmesi ve takibi
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Date
2014
Authors
Sancak, Yasemin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Antenatal hidronefroz (ANH), antenatal dönemde ultrasonografi (USG) ile incelemede en sık saptanan genitoüriner sistem anomalisidir. Antenatal hidronefroz en sık saptanan genitoüriner sistem anomalisi olmasına rağmen, postnatal dönemde bu hastaların değerlendirilmesi ve izlemi ile ilgili bilgiler hakkında görüş birliği yoktur. Bu çalışmada antenatal dönemde tanı almış olguların postnatal takipleri retrospektif olarak incelendi. Ocak 2000 ile Aralık 2012 tarihleri arasında antenatal hidronefroz tanılı 364 hasta (244 erkek, 120 kız) incelendi. Çalışmaya dahil edilen prenatal USG'de ünilateral veya bilateral çeşitli derecelerde hidronefroz saptanan 364 hastanın toplam 482 böbreğinin postnatal ilk USG'lerinde renal pelvis AP çaplarına göre, 185'inde hafif, 119'unda orta, 86'sında ağır derecede hidronefroz olduğu; 92 böbrekte ise hidronefroz bulunmadığı gösterildi. Postnatal ilk USG'de normal bulunan böbreklerin izleminde %29.4'ünde renal anomali saptandı. Postnatal USG'de hidronefroz derecesinin artmasıyla ile obstrüksiyon görülme riskinin arttığı tespit edildi. Çalışma sonunda antenatal hidronefrozlu hastalarda İYE geçirme riski istatistiksel olarak anlamlı yüksek bulundu (p<0.05). Antenatal hidronefrozun tekrarlayan İYE sebebiyle renal skar zemininde büyüme-gelişme geriliği ve malnütrisyona neden olabileceği saptandı. Sonuç olarak ANH' un persiste etmesi büyüme-gelişme ve beslenme durumunu etkilediği, persiste eden hidronefrozun İYE ile anlamlı ilişkisi olduğu ve bu üç durumun birlikteliği ile beslenme büyüme-gelişme üzerine olumsuz etkide olduğu saptanmıştır.
Hydronephrosis is the most common genitourinary system anomaly detected by USG during antenatal period. Although antenatal hydronephrosis is commonly seen there is no concensus about the follow-up during the postnatal period. This retrospective study is performed to investigate the postnatal management of the cases with prenatally detected hydronephrosis. Between January 2000 and December 2012 a total of 364 newborn ( 244 boys and 120 girls ) were diagnosed as having ANH. In the study, 482 kidneys of 364 patients with various degrees of unilateral or bilateral prenatal hydronephrosis were included. According to the renal pelvis APD of the kidneys measured in the first postnatal USG, 185 of them had mild, 119 had modarate, 86 had severe hydronephrosis; there was no hydronephrosis in 92 kidneys. In the follow-up 29.4 % of the kidneys that were normal in the first postnatal USG had renal pathologies. We found out that the risk of obstruction increased significantly with the increase in the degree of hydronephrosis in the first USG. It was found that; ANH was associated with urinary tract infection (p<0.05). Patients with ANH who had recurrent urinary tract infection with renal scaring were found to have malnutrition and growth retardation. According to the results of this study, ANH with urinary tract enfections may cause growth retardation and malnutrition.
Hydronephrosis is the most common genitourinary system anomaly detected by USG during antenatal period. Although antenatal hydronephrosis is commonly seen there is no concensus about the follow-up during the postnatal period. This retrospective study is performed to investigate the postnatal management of the cases with prenatally detected hydronephrosis. Between January 2000 and December 2012 a total of 364 newborn ( 244 boys and 120 girls ) were diagnosed as having ANH. In the study, 482 kidneys of 364 patients with various degrees of unilateral or bilateral prenatal hydronephrosis were included. According to the renal pelvis APD of the kidneys measured in the first postnatal USG, 185 of them had mild, 119 had modarate, 86 had severe hydronephrosis; there was no hydronephrosis in 92 kidneys. In the follow-up 29.4 % of the kidneys that were normal in the first postnatal USG had renal pathologies. We found out that the risk of obstruction increased significantly with the increase in the degree of hydronephrosis in the first USG. It was found that; ANH was associated with urinary tract infection (p<0.05). Patients with ANH who had recurrent urinary tract infection with renal scaring were found to have malnutrition and growth retardation. According to the results of this study, ANH with urinary tract enfections may cause growth retardation and malnutrition.
Description
Keywords
Antenatal hidronefroz, Hidronefroz, Antenatal hydronephrosis, Hydronephrosis
Citation
Sancak, Y. (2014). Antenatal hidronefroz tanısı alan çocukların postnatal değerlendirilmesi ve takibi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.