Prenatal imaging features and postnatal outcomes of isolated fetal duplex renal collecting system: A systematic review and meta‐analysis. (28th January 2020)

• Record Type: Journal Article
• Authors: Bascietto, Francesca; Khalil, Asma; Rizzo, Giuseppe; Makatsariya, Alexander; Buca, Danilo; Silvi, Claudia; Ucci, Matteo; Liberati, Marco; Familiari, Alessandra; D'Antonio, Francesco
• Is Part Of: Prenatal diagnosis. Volume 40:Number 4(2020)
• Page Start: 424
• Page End: 431
• Publication Date: 2020-01-28
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.5622
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Objectives: To perform a systematic review of studies reporting the outcome of fetuses with a prenatal diagnosis of isolated duplex collecting system (DCS). Methods: Inclusion criteria were studies reporting the outcome of fetuses with a prenatal diagnosis of isolated DCS, defined as DCS not associated with other major structural anomalies at the time of diagnosis. The outcomes observed were: imaging features of DCS on prenatal ultrasound, associated anomalies detected exclusively at prenatal follow‐up ultrasound and at birth, abnormal karyotype, symptoms at birth (including vesicoureteral reflux [VUR] and urinary tract infections [UTI]), need for and type of surgical approach, complications after surgery, and accuracy of prenatal ultrasound in correctly identifying this anomaly. Results: Eleven studies (284 fetuses with a prenatal diagnosis of DCS) were included. On ultrasound, DCS was associated with ureterocele in 70.7% and with megaureter in 36.6% of cases. Worsening of pelvic/ureteric dilatation was reported to occur in 41.3% of fetuses. At birth, 4.3% of fetuses affected by DCS showed associated renal anomalies. After birth, VUR and UTI presented in 51.3% and 21.7% of children respectively, while 33.6% required surgery. Prenatal diagnosis of DCS was confirmed in 90.9% of included cases. Conclusion: DCS diagnosed prenatally is associated with a generally good outcome. Prenatal ultrasound has a good diagnostic accuracy, while detailed postnatal assessment is required in order to identify associated renal anomalies.