The Detection and Assessment of Fetal Urinary-Tract Anomalies Via Ultrasound
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Authors
Garcia, Eduardo Javier
Issue Date
1988
Type
Thesis
Language
en_US
Keywords
Alternative Title
Abstract
The case studies of 36 prenatal examinations diagnosed, via
ultrasound, for fetal uropathic conditions over a 37 month period,
were examined to determine the divergence between the intrauterine
diagnostic ultrasound findings and the diagnoses made after
delivery. Data concerning these cases was generated through the use
of 4 different sources: an initial list of cases afflicted with some
type of uropathy from Hutzel Hospital's computer network; hospital
charts from the Medical Records Department at Hutzel; ultrasound
reports from the Ultrasound Department at Hutzel; and post-delivery
neonatal follow-up reports from the Medical Records Department at
the Children's Hospital of Michigan. Upon obtaining the desired
information for each case, the following data was looked at for each
case: 1.) name and social security/hospital number of mother and
child; 2.) maternal age; 3.) parity; 4.) gestational age of the fetus
at first ultrasound (U/S); 5.) gestational age at U/S diagnosis; 6.)
amniotic fluid volume; 7.) maternal alpha fetal protein results; 8.)
karyotype of the fetus; 9.) fetal presentation; 10.) gestational age
of the fetus at delivery; 11.) mode of delivery; 12.) whether or not
a therapeutic abortion was performed; 13.) sex of the fetus; 14.)
family and maternal history; 15.) fetal urine electrolytes, (blood
urea nitrogen and creatinine levels); 16.) U/S findings; 17.) autopsy
findings; 18.) neonatal follow-up and postnatal treatment.
Correct diagnoses were made in 26 of the cases, (67 per cent)
and predominated in male sexual phenotypes. Oligohydramnios was
found to be the major limiting factor in neonatal survival and the
primary means of uropathy detection, (50 per cent of the cases had
this condition). In addition to this, it was found that other major
congenital anomalies involving other organ systems were associated
with oligohydramnios with a high frequency. The importance of the
difference in gestational ages of the fetus between initial
ultrasound examination and ultrasound diagnosis of uropathies, 20
weeks and 28 weeks respectively, was examined. Finally, since
there exists an association between urinary-tract anomalies and
some major congenital anomalies, such as pulmonary hypoplasia, the
early evaluation of uropathies, before irreversible damage was done,
was found to be imperative in the management of the pregnancy.
Description
vii, 31 p.
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