The Predictive Value Of Ultrasound Parameters In The Operation Of Ureteropelvic Junction Obstruction

Objective: To analyze the predictive value of ultrasound parameters before and after birth in the follow-up period of children with ureteropelvic junction obstruction,and to explore the critical value of predicting the operation of the diameter of the anteroposterior renal pelvis diameter.Methods: The clinical data of fetal hydronephrosis with APD ? 4mm in the second trimester or APD ? 7mm in the third trimester detected by ultrasound in Hunan children's Hospital and Hunan maternal and child health hospital from June 2017 to March 2019 were analyzed retrospectively.During the follow-up,the postnatal outcome of children with fetal hydronephrosis was divided into operation group and non-operation group.Result:In this study,98 children(161 kidneys)were included,36 children(40 kidneys)underwent pyeloplasty because of the indication of clinical operation.Univariate analysis showed that there were significant differences in renal parenchymal thickness,APD and SFU grades between the operation group and the non operation group in the mid pregnancy,the late pregnancy and the first month after birth.Multivariate logistic regression analysis showed that APD value in the second trimester(OR = 1.078,95% CI: 0.950-1.224),APD value in the third trimester(OR = 1.219,95% CI: 1.116-1.331)and APD value in the first month after birth(OR = 1.215,95% CI = 1.066-1.386)were risk factors for pyeloplasty.The value of APD in the second trimester,the third trimester and the first month after birth was used to distinguish the area under the curve(AUC)was 0.801,0.842 and 0.915,the critical values were 7.5mm,16.4mm and 15.5mm,the sensitivity was 75.7%,70.3% and 83.8%,the specificity was 79.0%,90.0% and 87.0%.Conclusion:APD values in the second,third and one month after birth were risk factors for pyeloplasty in children with hydronephrosis.Sfu3-4 and renal parenchyma thickness were not risk factors for pyeloplasty in children with UPJO.The critical value of postnatal pyeloplasty for UPJO children can be predicted better in the third trimester and one month after birth,but the children with high risk of operation can be screened in the second trimester.