ANTENATAL DOUBT AND POSTNATAL DIAGNOSIS OF URINARY ANOMALY

Urinary tract and renal abnormalities represent 20% of all congenital malformations.Prenatal fetal ultrasonography revealed data of echostructure of renal parenchyma, dilatation of urinary sistem and visualisation of the fetal bladder after 16 weeks of gestation.Pyelic dilatation is considered when the anteroposterior diameter exceeds 4 mm before and 7 mm after 33 th week of gestation.All the children with antenatal doubt of urinary malformation should be examined. In the last 2 years we examined 25 newborns with antenatal doubt about urinary abnormalities. Multicystic dysplastic kidney was identified in 20%, posterior urethral valves in 12%, ureterocela in 8%, vesicoureteric junction anomaly in 24%, and high grade VUR in 32%. In the secound group of newborns, which was at the same time controlled due to the postnatally revealed hydronephrosis, our annual follow-up showed that there was spontaneous reduction of changes in 50% of cases, while in 25% of cases we revealed the reflux and vesicouretheric junction anomaly in 25%.Prenatally diagnosed hydronephrosis is more severe than hydronephrosis of the same degree revealed postnatally. Hydronephrosis in the first postnatal days in sterile urine conditions has spontaneous regression in one third of examined children.