Club de revistas. Hidronefrosis fetal. Revisión sistemática.

van Eerde AM, Meutgeert MH, de Jong TP, Giltay JC. Vesico-ureteral reflux in children with prenatally detected hydronephrosis: a systematic review. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2007 Apr;29(4):463-469.

To investigate the value of prenatally detected hydronephrosis (PNH) as a prognostic factor for vesico-ureteral reflux (VUR). The MEDLINE database was searched for articles on PNH and VUR published between 1980 and 2004. A total of 18 studies were identified and reviewed for various aspects. Results were separated for primary and/or secondary VUR whenever possible, because of the different underlying pathogenic mechanisms. There was considerable variation between the different studies with respect to methodology and study design. One of the main discrepancies was the way in which postnatal abnormalities were ascertained: by postnatal ultrasound, voiding cystourethrogram (VCUG) alone, or combined or sequential ultrasound and VCUG. Taking these limitations into account, the published data showed there to be a mean prevalence of 15% for postnatal primary VUR after PNH. Of all patients with PNH, 53% had no postnatal anomalies, whereas 29% had other anomalies, such as duplex collecting systems. Of all infants with PNH, 15% had primary VUR proven postnatally and 53% had no other anomalies detected. We suggest a standardized protocol for future studies, to enable better comparison of follow-up protocols.

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Club de revistas

Clayton DB, Brock JW 3rd. Prenatal ultrasonography: Implications for pediatric urology. J Pediatr Urol. 2011 Apr;7(2):118-25. Epub 2011 Jan 12.

Prenatal ultrasonography has become a critical and integral component of the obstetric care of women worldwide. As a result, a number of congenital anomalies are now routinely being detected prior to birth. Anomalies affecting the genitourinary system are among those most commonly detected, and thus pediatric urologists are increasingly being asked to provide parental counseling in such situations. However, much of the data needed to enhance these discussions and provide informed consent are absent from the literature. In this review, we hope to address the published literature describing the rapidly expanding role of ultrasound in prenatal care. More importantly, however, we hope to provide some insight into the manner in which prenatal ultrasound and subsequent urologic anomaly diagnosis has affected the practice of pediatric urology.

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