Kliniğimizde takibi yapılan ciddi fetal hidronefroz vakalarının postpartum sonuçları

Bu çalışmadaki amaç, kliniğimizde takibi yapılan ciddi fetal hidronefroz vakalarının postpartum dönem sonuçlarını değerlendirmek ve fetal hidronefrozun önemini vurgulamaktır. Çalışmaya, fetal böbrek renal pelvis antero-posterior çapı >15 mm olan 10 hasta alındı. Hastaların postpartum erken ve geç dönem fetal sonuçları değerlendirildi. Toplam 8 (%80) fetüste renal pelvik dilatasyon sol böbrekte, 1 (%10) fetüste sağ böbrekte ve 1 (%10) fetüste bilateral idi. Fetüslerin biri hariç tamamı erkekti. Postpartum dönemde 3 bebeğe perkütan renal katater takıldı. Bunlardan ikisine sonraki dönemde pyeloplasti, birine nefrektomi uygulandı. Bir bebek intrauterin kaybedildi. Toplam 6 bebekte ise hidronefroz tamamen geriledi. Sonuç olarak, ciddi hidronefrozlar önemli morbidite ve mortalite nedenidir. Hem antenatal dönem, hem de postnatal dönem yakın takip önemlidir. Ancak bu vakaların büyük çoğunluğunun postpartum gerilediği düşünülürse, gebeliğin erken sonlandırılması doğru değildir. Anahtar Kelimeler: Fetal hidronefroz, postpartum dönem, pyeloplasti The postpartum results of the serious fetal hydronephrosis cases in our clinic Abstract The aim of the study is to evaluate the outcome of serious fetal hydronephrosis in the postpartum period and highlight the importance of fetal hydronephrosis. 10 patients whose fetal kidney pelvic anterioposterior diameter greater than 15 mm have been taken in the study. Patient's fetal results were evaluated in early and postpartum period. Renal pelvic dilatation in left kidney in 8 (%80) of patients, dilatation in right kidney in 1 (%10) and bilateral dilatation in 1 (%10) of fetus were observed. Except one of the fetus, all of them were male. In postpartum period, 3 fetuses were catheterized percutaneously. 2 of the fetus had pyeloplasty and 1 fetus had nephrectomy in later period. 1 of the fetus died intrauterine. Hydronephrosis completely regressed in 6 of the babies. In conclusion, serious hydronephrosis is an important cause of the morbidity and the mortality. Both antenatal and postnatal period's intensive care is important. However most of these cases in postpartum period hydronephrosis regressed, so early termination of the pregnancy is not suitable. Keywords: Fetal hydronephrosis, postpartum period, pyeloplasty.

Anahtar Kelimeler:

Fetal hidronefroz, postpartum dönem, pyeloplasti

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Aviram R, Pomeranz A, Sharony R, Beyth Y, Rathaus V, Tepper R. The increase of renal pelvis dilatation in the fetus and its significance. Ultrasound Obstet Gynecol 2000;16:60-2.
Pates JA, Dashe JS. Prenatal diagnosis and management of hydronephrosis. Early Hum Dev 2006;82:3-8.
Ouzounian JG, Castro MA, Fresquez M, al-Sulyman OM, Kovacs BW. Prognostic significance of antenatally detected fetal pyelectasis. Ultrasound Obstet Gynecol 1996;7:424-8.
Chudleigh T. Mild pyelectasis. Prenat Diagn 2001;21:936-41.
Ismaili K, Hall M, Donner C, Thomas D, Vermeylen D, Avni FE; Brussels Free University Perinatal Nephrology study group. Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population. Am J Obstet Gynecol 2003;188:242-6.
Mandell J, Blyth BR, Peters CA, Retik AB, Estroff JA, Benacerraf BR. Structural genitourinary defects detected in utero. Radiology 1991;178:193-6.
Wollenberg A, Neuhaus TJ, Willi UV, Wisser J. Outcome of fetal renal pelvic dilatation diagnosed during the third trimester. Ultrasound Obstet Gynecol 2005;25:483-8.
Feldman DM, DeCambre M, Kong E, Borgida A, Jamil M, McKenna P, et al. Evaluation and follow-up of fetal hydronephrosis. J Ultrasound Med 2001;20:1065-9.
Persutte WH, Koyle M, Lenke RR, Klas J, Ryan C, Hobbins JC. Mild pyelectasis ascertained with prenatal ultrasonography is pediatrically significant. Ultrasound Obstet Gynecol 1997;10:12-8.
Benacerraf BR, Mandell J, Estroff JA, Harlow BL, Frigoletto FD Jr. Fetal pyelectasis: a possible association with Down syndrome. Obstet Gynecol 1990;76:58-60.
Chudleigh PM, Chitty LS, Pembrey M, Campbell S. The association of aneuploidy and mild fetal pyelectasis in an unselected population: the results of a multicenter study. Ultrasound Obstet Gynecol 2001;17:197-202.
Thornburg LL, Pressman EK, Chelamkuri S, Hulbert W, Rabinowitz R, Mevorach R. Third trimester ultrasound of fetal pyelectasis: predictor for postnatal surgery. J Pediatr Urol 2008;4:51-4.
Önen A. Hidronefrozlarýn doðum sonrasý doðal seyri ve takip-tedavi yaklaþýmý. Çocuk Cerrahisi Dergisi 2006;20:33-8.
Gramellini D, Fieni S, Caforio E, Benassi G, Bedocchi L, Beseghi U, et al. Diagnostic accuracy of fetal renal pelvis anteroposterior diameter as a predictor of significant postnatal nephrouropathy: second versus third trimester of pregnancy. Am J Obstet Gynecol 2006;194:167-73.
Ahmad G, Green P. Outcome of fetal pyelectasis diagnosed antenatally. J Obstet Gynaecol 2005;25:119- 22.
Signorelli M, Cerri V, Taddei F, Groli C, Bianchi UA. Prenatal diagnosis and management of mild fetal pyelectasis: implications for neonatal outcome and follow-up. Eur J Obstet Gynecol Reprod Biol 2005;118:154-9.
Woodward M, Frank D. Postnatal management of antenatal hydronephrosis. BJU Int 2002;89:149-56.

ISSN: 1300-7416
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 2015
Yayıncı: Süleyman Demirel Üniversitesi

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