Outcome of isolated fetal renal pyelectasis diagnosed during midtrimester screening ultrasound and cut-off value to predict a persistent or progressive pyelectasis in utero

J Perinat Med. 2013 Jul;41(4):401-9. doi: 10.1515/jpm-2012-0214.

Abstract

Aim: To define a better cut-off value of the renal pelvis anteroposterior diameter (RPAPD) to predict persistent or progressive pyelectasis during pregnancy.

Methods: We retrospectively reviewed 8873 women whose fetal RPAPD was measured. Midtrimester pyelectasis was defined as a RPAPD of ≥4 mm. Persistent/progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery. A RPAPD cut-off value to predict a persistent/progressive pyelectasis was determined by receiver operating characteristic curve analysis.

Results: Among 249 isolated cases of pyelectasis, persistent/progressive pyelectasis was found in 6.9% before delivery. The midtrimester RPAPD cut-off value that best predicted persistent/progressive pyelectasis before delivery was ≥6 mm with sensitivity, specificity, positive and negative predictive values of 64.3%, 88.7%, 30.0%, and 97.1%, respectively.

Conclusions: Although most cases of midtrimester fetal pyelectasis regress to normal during pregnancy, those with a RPAPD of ≥6 mm in the midtrimester are at higher risk for persistent or progressive pyelectasis.

MeSH terms

  • Adult
  • Disease Progression
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Kidney Pelvis / diagnostic imaging
  • Male
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome
  • Prognosis
  • Pyelectasis / diagnostic imaging*
  • Remission, Spontaneous
  • Retrospective Studies
  • Ultrasonography, Prenatal / statistics & numerical data