Detection of renal anomalies using antenatal and postnatal ultrasound

Abstract

Introduction: Antenatal ultrasound (US) is considered the gold standard tool to detect fetal anomalies during the antenatal period. However, its highly operator dependent and maybe affected with other variables. The aim of this study to compare discrepancy between antenatal and postnatal US diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT) and to evaluate the incidence of parent’s consanguinity among those patients at King Abdulaziz Medical City – Western Region (KAMC-WR), as it may help changing the current practiced guidelines and applied protocols. Methods: This is an observational, retrospective, cross-sectional study, conducted at the Maternal Fetal Medicine Unit at KAMC-WR, reviewing antenatally detected CAKUT between the years 2009 and 2014. Utilizing the congenital anomalies database and using multiple databases collected the data. A data sheet was completed and divided into four sections, which consist of maternal data, antenatal data, delivery, and postnatal data. The analysis was performed using Statistical Package for Social Sciences program (Armonk, NY: IBM Corp). Results: We included 137 fetuses with renal anomalies in our study, with 17% perinatal mortality rate, and 13% loss of follow-up. Abnormal amniotic fluid was detected in 32%, and bilateral anomalies presented in 41% and it was most commonly seen in male fetuses. Added to that, 41% of the fetuses were product of consanguineous marriage and 11% had a history of other child with renal anomalies. However, the rate of discrepancy between antenatal and postnatal renal US findings was 24%. Finally, the most common anomaly found antenatally and confirmed postnatally was hydronephrosis disease spectrum (60.6%). Conclusion: There is a significant association between children with CAKUT and parents’ consanguinity. Furthermore, the discrepancy rate for the detection of CAKUT between antenatal and postnatal US in our study was comparable to other international studies. Further prospective studies are recommended in this field for further understanding.