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Diagnostic value of anteroposterior diameter of fetal renal pelvis during second and third trimesters in predicting postnatal surgery among Korean population: useful information for antenatal counseling

 Hyung Joon Kim  ;  Hyun Jin Jung  ;  Hye Young Lee  ;  Yong Seung Lee  ;  Young Jae Im  ;  Chang Hee Hong  ;  Sang Won Han 
 Urology, Vol.79(5) : 1132-1137, 2012 
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OBJECTIVE: To establish prognostic data regarding fetal hydronephrosis using the anteroposterior diameter (APD) and the need for interventional surgery in the Korean population. METHODS: A total of 187 children with an APD of ≥ 4 mm on obstetric ultrasound scans at any gestational age were retrospectively reviewed. The affected renal units were divided into 2 groups: surgical and nonsurgical. The ultrasound findings were compared at 3 gestational ages: second trimester (15-26 weeks' gestation), early third trimester (27-33 weeks' gestation), and late third trimester (34-40 weeks' gestation). RESULTS: The area under the receiver operating characteristic curve was 0.770, 0.828, and 0.812 at the second, early third, and late third trimesters, respectively. A 100% sensitivity for predicting postnatal surgery could be achieved at a cutoff APD of 5 mm during the second trimester, 8 mm during the early third trimester, and 10 mm during the late third trimester if scheduled antenatal ultrasound scans were performed. A cutoff APD of 11 mm during the second trimester was of diagnostic value in selecting children at risk of postnatal surgery with an odds ratio of 5.13 (95% confidence interval 1.62-16.25), with relatively high sensitivity and specificity. With a cutoff of 15 mm during the early third and late third trimesters, the odds ratio was 11.51 (95% confidence interval 5.05-26.23) and 6.94 (95% confidence interval 3.30-14.57), respectively. CONCLUSION: Compared with an APD of 10 mm, the most commonly used standard cutoff value in predicting postnatal hydronephrosis and its outcome, an APD cutoff of 5, 8, and 10 mm during the second, early third, and late third trimesters, respectively, is more specific in predicting the need for postnatal surgical intervention in the Korean population.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Lee, Hye Young(이혜영)
Im, Young Jae(임영재)
Jung, Hyun Jin(정현진)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
Hong, Chang Hee(홍창희) ORCID logo https://orcid.org/0000-0002-0946-7702
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