Bascietto, F; Khalil, A; Rizzo, G; Makatsariya, A; Buca, D; Silvi, C; Ucci, M; Liberati, M; Familiari, A; D'Antonio, F
(2020)
Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: a systematic review and meta-analysis.
Prenat Diagn, 40 (4).
pp. 424-431.
ISSN 1097-0223
https://doi.org/10.1002/pd.5622
SGUL Authors: Khalil, Asma
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Abstract
OBJECTIVES: To perform a systematic review of studies reporting the outcome of fetuses with a prenatal diagnosis of isolated duplex collecting system (DCS). METHODS: Inclusion criteria were studies reporting the outcome of fetuses with a prenatal diagnosis of isolated DCS, defined as DCS not associated with other major structural anomalies at the time of diagnosis. The outcomes observed were: imaging features of DCS on prenatal ultrasound, associated anomalies detected exclusively at prenatal follow-up ultrasound and at birth, abnormal karyotype, symptoms at birth [including vesicoureteral reflux (VUR), urinary tract infections (UTI)], need for and type of surgical approach, complications after surgery and accuracy of prenatal ultrasound in correctly identifying this anomaly. RESULTS: Eleven studies (284 fetuses with a prenatal diagnosis of DCS) were included. On ultrasound, DCS was associated with ureterocele in 70.7% and with megaureter in 36.6% of cases. Worsening of pelvic/ureteric dilatation was reported to occur in 41.3% of fetuses. At birth, 4.3% of fetuses affected by DCS showed associated renal anomalies. After birth, VUR and UTI presented in 51.3% and 21.7% of children respectively, while 33.6% required surgery. Prenatal diagnosis of DCS was confirmed in 90.9% of included cases. CONCLUSION: DCS diagnosed prenatally is associated with a generally good outcome. Prenatal ultrasound has a good diagnostic accuracy, while detailed post-natal assessment is required in order to identify associated renal anomalies. This article is protected by copyright. All rights reserved.
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