Value Of Prenatal Ultrasound In Predicting The Development Of Pyelolysis In Different Fetuses

Objective: To analyze the ultrasonographic value and clinical prognosis of fetal renal pelvis separation in the second and third trimester of pregnancy,and to explore the related factors of fetal hydronephrosis and its prognosis.Methods: A total of 161 singleton fetuses with hydronephrosis who had APD ≥ 4 mm in the second trimester or APD ≥7 mm in the third trimester in the Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2019 were selected.The final outcome of fetal hydronephrosis found in the second and third trimesters was the first detection of fetuses with pathological hydronephrosis and the optimal cutoff value,sensitivity and specificity of APD were analyzed by establishing the receiver operating characteristic(ROC)curve.Logistic regression was applied for in-depth analysis to find ultrasound parameters that could accurately assess the necessity of surgery.Results: A total of 161 fetuses with hydronephrosis were included in this study,of which 89 were detected for the first time in the second trimester,72 were detected for the first time in the third trimester,133(82.6%)hydronephrosis disappeared during follow-up,only 28(17.3%)developed pathological hydronephrosis,of which 12(7.4%)underwent postnatal surgery.ROC curve analysis showed that when the APD value of fetal hydronephrosis was 7.5 mm in the second trimester,the sensitivity was 62.5%,the specificity was 95.9%,and the Youden index was 0.584;when the APD cut-off value of12.5 mm was taken in the third trimester,the sensitivity was 66.7%,the specificity was91.7%,and the Youden index was 0.583.Logistic regression analysis showed that the size of anteroposterior diameter of fetal renal pelvis and the side of hydronephrosis before delivery were independent risk factors for assessing postpartum surgery.Conclusion: Most fetuses with hydronephrosis can subside spontaneously after birth,and children with hydronephrosis need regular ultrasound examination after birth.APD in the second and third trimester can predict the probability of pathological hydronephrosis after birth to a certain extent.Dynamic follow-up of APD value of fetal hydronephrosis by prenatal ultrasound combined with the first detection of hydronephrosis and hydrops side can improve the accuracy of clinical diagnosis;for further aggravated cases,the prognosis of early fetal life surgery is good.