胎儿尿道梗阻的宫内诊断和治疗

Intrauterine diagnosis and therapy of fetal urinary tract obstruction

泌尿道扩张表现为肾盂扩张伴(或不伴)输尿管或膀胱扩张,是产前超声筛查能检测到的比较常见的异常之一。上尿道梗阻的常见原因,包括肾盂输尿管连接部梗阻、输尿管膀胱连接部梗阻、膀胱输尿管返流。男性下尿道梗阻最常见的原因是后尿道瓣膜,而女性最常见的原因是尿道狭窄。产前诊断主要依靠超声检查,并结合胎儿MRI和血尿的生化分析。泌尿道梗阻的自然史仍在研究中,因此出生后才能做出准确的诊断和预后评估。

Urinary tract dilatation presenting as renal pelvis dilatation with or without urethral or bladder dilatation is one of the more common abnormalities detected on prenatal ultrasound scanning. The majority of upper urinary tract obstruction is due to ureteropelvie and ureterovesical junction anomalies, and vesicoureteric reflux. Urinary tract obstruction at the level of the bladder outlet is usually due to posterior urethral valves in male fetus and urethral atresia in females. Prenatal diagnosis is made mainly by uhrasound, combined with fetal MRI and biochemical analysis of fetal blood and urine. The natural history of prenatally detected abnormalities remains under review. Precise diagnosis, and therefore prognosis, may not be made until after birth.