A Study On The Correlation Between Anteropodterior Renal Pelvic Diameter And Differential Renal Function And The Outcomes Of Fetal Hydronephrosis

Objective: The purpose of this study was to explore the evolution and prognosis of fetal hydronephrosis,and provide relative quantitative prenatal evaluation and postnatal follow-up and treatment plan for fetal hydronephrosis.Method: A retrospective analysis was performed on 245 children with unilateral fetal hydronephrosis diagnosed in our hospital from January 2015 to January 2017.The samples were grouped according to age,side,spontaneous heating,pyeloplasty,and whether renal function was more than 40% before operation.The anteropodterior renal pelvic diameter(APD)of the late pregnancy and 1 weeks after birth 、preoperative and postoperative differential renal function(DRF)were collected.Result: 1.There was no statistical difference about the sex and the side of the hydronephrosis between the spontaneous heating group and the observation group,the non operation group and the operation group(P>0.05);2.The APD in the late stage of pregnancy and 1 week after the birth is of predictive significance for the spontaneous healing of fetal hydronephrosis and whether or not pyeloplasty was needed,(P < 0.05);3.The best cutoff point of APD in the late stage of pregnancy stage and the 1 week after birth that lead to resolved spontaneously were 0.83 cm VS 1.2cm,with sensitivity 83%VS 93%,specificity 71% VS 76%,and the ROC curve showed an AUC of 0.86 VS 0.79.The best cutoff point of APD in the third pregnancy stage and the first week after birth that led to surgery were 1.9cm VS 1.9cm,with sensitivity 68% VS 78%,the specificity71% VS 69%,and the ROC curve showed an AUC of 0.71 VS 0.78;4.Combining two indicators were more accurate than the single indicator in predicting the accuracy of postpartum resolved spontaneously and pyeloplasty(0.87 VS 0.84);5.The improvement of renal function was significantly higher than DRF ≥40% of patients with DRF < 40%group,(P=0.0028),but the postoperative renal function did not reach the postoperative renal function of the DRF ≥40% group.Conclusion: 1.The sex and side can not predict the spontaneous healing after birth and the operation of pyeloplasty;2.APD of fetal at the third trimester and 1 weeks after birth is of great reference value for predicting the prognosis of unilateral fetal hydronephrosis;3.In patients with persistent hydronephrosis and the renal graph showsobstruction,timely surgical treatment after close clinical monitoring is beneficial to the protection of renal function.