- 作者：Antonio ZACCARA Cristina BRISSI ; Laura MOBILI ; Claudio GIORLANDINO ; Irma CAPOLUPO ; Pietro BAGOLAN ; Mario DE GENNARO
- 刊名：Journal of Pediatric Urology
- 出版年：2007
- 出版时间：April 2007
- 年：2007
- 卷：3
- 期：Supplement 1
- 页码：S32
- 全文大小：38 K
PURPOSE
Oligohydramnios (OI) has long been considered a good marker of Urinary Tract Abnormalities (UTA) and, as such, it usually has an early and progressive onset with poor prognosis However no reports exist about an abrupt decrease of Amniotic Fluid (AF) in pregnancies with UTA.MATERIAL AND METHODS
28 cases of Bilateral Obstructive Uropathy (BOO) were seen at our Institution. All cases had the diagnosis made between 17 and 20 weeks g.a. with bilateral hydro, distended bladder and dilated posterior urethra. Amniotic Fluid Index (AFI) and its variations throughout pregnancy were recorded at each follow up encounter. Fetuses with OI since diagnosis were excluded from the study as were those with persistently normal AFI.
RESULTS
A sudden decrease in AFI (<5th centile) was found in 5 fetuses: this occurred at 31 weeks in 2 fetuses, at 34 weeks in 2 and at 37 weeks in the remaining one.All fetuses were delivered by C- Section: the two fetuses at 31 weeks underwent one amnioinfusion prior to delivery. The urological diagnosis was urethral atresia in one case, posterior urethral valves in three and prunebelly syndrome in one. All patients had dilated ureters on a voiding cystogram with grade V monolateral reflux. At six months follow up RF is normal in three patients, mildly impaired in one and severely impaired in one.
CONCLUSIONS
OI of renal origin may also have a delayed, acute onset which may be speculatively related to a pop off mechanism at the vesico-ureteric junction producing gross reflux. Unlike cases with progressive decline, acute onset OI is not necessarily associated with deterioration of RF later in life and its prognostic value must be evaluated with caution.