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Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling

Objective. The objective of this study was to determine the visualizing rate of fetal kidneys at various gestational ages in late first trimester (FT) and to establish the clinical significance of their two-dimensional ultrasound (2DUS) appearance in the FT. Methods. In a prospective cross-sectional...

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Autores principales: TUDORACHE, Ș., CARA, M., ILIESCU, D.G., STOICA, A., SIMIONESCU, C., NOVAC, L.V., CERNEA, D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medical University Publishing House Craiova 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256139/
https://www.ncbi.nlm.nih.gov/pubmed/30568808
http://dx.doi.org/10.12865/CHSJ.42.01.03
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author TUDORACHE, Ș.
CARA, M.
ILIESCU, D.G.
STOICA, A.
SIMIONESCU, C.
NOVAC, L.V.
CERNEA, D.
author_facet TUDORACHE, Ș.
CARA, M.
ILIESCU, D.G.
STOICA, A.
SIMIONESCU, C.
NOVAC, L.V.
CERNEA, D.
author_sort TUDORACHE, Ș.
collection PubMed
description Objective. The objective of this study was to determine the visualizing rate of fetal kidneys at various gestational ages in late first trimester (FT) and to establish the clinical significance of their two-dimensional ultrasound (2DUS) appearance in the FT. Methods. In a prospective cross-sectional study, 1456 women from an unselected population underwent a detailed assessment of fetal anatomy at 11+0 -13+4 weeks of gestation with the use of transabdominal sonography. Information on the ultrasound findings, antenatal course and perinatal outcome was obtained in 1331 cases. Results. 44 cases in which a congenital kidney disease was detected by ultrasound in the prenatal period were identified. The renal pathology was suspected in the FT in 8 cases, and confirmed by a standard test (postmortem autopsy or second-trimester scan) in 4 cases. The standard detailed second-trimester scan at 18-22 weeks diagnosed another 23 cases but refuted suspicion in 4 FT positive cases. The third trimester added another 17, all confirmed by the postpartum scan. For FT presence or absence of congenital renal anomalies, sensitivity, specificity, +LRs and -LRs of 2DUS were 9.09%, 99.69%, 29.25, and 0.91. Conclusion. FT prenatal kidneys’ visualization is critically dependent on the gestational age. FT diagnosis holds uncertainty. An early diagnosis carries a risk of providing a false-positive or a false-negative result, because the differentiation of the renal system is delayed or the diagnosis is not amenable yet to prenatal ultrasound. No FT findings can exclude the mid-trimester follow-up ultrasound scan. Second and third trimester scan are relevant for congenital kidney diseases.
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spelling pubmed-62561392018-12-19 Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling TUDORACHE, Ș. CARA, M. ILIESCU, D.G. STOICA, A. SIMIONESCU, C. NOVAC, L.V. CERNEA, D. Curr Health Sci J Original Paper Objective. The objective of this study was to determine the visualizing rate of fetal kidneys at various gestational ages in late first trimester (FT) and to establish the clinical significance of their two-dimensional ultrasound (2DUS) appearance in the FT. Methods. In a prospective cross-sectional study, 1456 women from an unselected population underwent a detailed assessment of fetal anatomy at 11+0 -13+4 weeks of gestation with the use of transabdominal sonography. Information on the ultrasound findings, antenatal course and perinatal outcome was obtained in 1331 cases. Results. 44 cases in which a congenital kidney disease was detected by ultrasound in the prenatal period were identified. The renal pathology was suspected in the FT in 8 cases, and confirmed by a standard test (postmortem autopsy or second-trimester scan) in 4 cases. The standard detailed second-trimester scan at 18-22 weeks diagnosed another 23 cases but refuted suspicion in 4 FT positive cases. The third trimester added another 17, all confirmed by the postpartum scan. For FT presence or absence of congenital renal anomalies, sensitivity, specificity, +LRs and -LRs of 2DUS were 9.09%, 99.69%, 29.25, and 0.91. Conclusion. FT prenatal kidneys’ visualization is critically dependent on the gestational age. FT diagnosis holds uncertainty. An early diagnosis carries a risk of providing a false-positive or a false-negative result, because the differentiation of the renal system is delayed or the diagnosis is not amenable yet to prenatal ultrasound. No FT findings can exclude the mid-trimester follow-up ultrasound scan. Second and third trimester scan are relevant for congenital kidney diseases. Medical University Publishing House Craiova 2016 2016-03-29 /pmc/articles/PMC6256139/ /pubmed/30568808 http://dx.doi.org/10.12865/CHSJ.42.01.03 Text en Copyright © 2016, Medical University Publishing House Craiova http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
spellingShingle Original Paper
TUDORACHE, Ș.
CARA, M.
ILIESCU, D.G.
STOICA, A.
SIMIONESCU, C.
NOVAC, L.V.
CERNEA, D.
Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title_full Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title_fullStr Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title_full_unstemmed Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title_short Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
title_sort fetal kidneys ultrasound appearance in the first trimester - clinical significance and limits of counseling
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256139/
https://www.ncbi.nlm.nih.gov/pubmed/30568808
http://dx.doi.org/10.12865/CHSJ.42.01.03
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