胎儿先天性肾脏异常孕中期超声表现及其转归

Ultrasonic manifestations and outcomes of fetal congenital kidney anomalies during the second trimester of pregnancy

目的观察先天性肾脏异常(CKA)胎儿孕中期超声表现及其转归。方法回顾性分析223胎于孕中期检出CKA的单胎胎儿资料,观察其孕中期超声表现,以及孕晚期肾脏变化。结果223胎CKA中,孕中期超声显示142胎单纯肾盂分离、41胎单纯双肾盂畸形、11胎多囊肾病、7胎肾缺如、6胎单纯肾囊肿、6胎异位肾、4胎肾偏小、2胎马蹄肾、2胎单侧肾盂分离伴对侧肾双肾盂畸形及单侧肾囊肿伴对侧肾双肾盂畸形、单侧肾双肾盂畸形伴肾盂分离各1胎。孕晚期可见肾盂分离、肾盂畸形、肾囊肿及肾偏小等发生变化,而多囊肾病、肾缺如、异位肾及马蹄肾等多无显著改变。结论胎儿CKA类型多样,以肾盂分离最常见,可随妊娠进展而发生动态变化。

Objective To observe the ultrasonic manifestations and outcomes of fetal congenital kidney anomalies(CKA)during the second trimester of pregnancy.Methods Data of 223 singleton fetuses with CKA detected with ultrasound during the second trimester of pregnancy were retrospectively analyzed.The ultrasonic manifestations of fetal CKA during the second trimester of pregnancy were observed,and the changes till the third trimester of pregnancy were analyzed.Results Among 223 CKA fetuses,simple renal pelvis separation was detected in 142 fetuses,while simple double renal pelvis malformation in was found in 41,polycystic kidney disease in 11,absent kidneys in 7,simple renal cysts and ectopic kidneys each in 6,smaller kidneys in 4,horseshoe kidneys and unilateral renal pelvis separation complicated with contralateral double renal pelvis malformation each in 2,unilateral renal cyst swelling complicated with contralateral double renal pelvis malformation and unilateral renal double renal pelvis malformation complicated with renal pelvis separation was noticed each in 1 fetus.Abnormalities such as renal pelvis separation,renal pelvis malformation,renal cysts and smaller kidney changed during the third trimester of pregnancy,while polycystic kidney disease,absent kidney,ectopic kidney and horseshoe kidney not significantly changed.Conclusion Fetal CKA had various types being able to change dynamically with the development of pregnancy,among which renal pelvis separation was the most common type.