Multiple Factors Of Ultrasonic Evaluation Method To Evaluate The Prenatal Diagnosis And Prognosis Of Fetal Hydronephrosis

Objective Use fetal ultrasound technology to evaluate the aluaanterior-posterior diameter of renal pelvis, thickness of renal parenchyma, renal artery blood flow resistance index and kidney calices expansion form, these four ultrasonic parameters. Discuss the ultrasonography score’s appraisal value to Prognostic fetal hydronephrosis, to provide a more accurate basis for clinical intervention.Methods Choose pregnant women whom did prenatal ultrasonic examinations at Obstetrics and Gynecology, B ultrasound room at the First Affiliated Hospital of Kunming Medical University from January 2013 to December 2014., set the pregnant women whose pregnancy≥20 weeks, and the anteroposterior diameter of fetal renal pelvis (APD)≥0.8cm as research object. Do routine ultrasound for those pregnant women, record the anteroposterior diameter of fetal renal pelvis (APD), with or without calyx expansion, renal parenchymal thickness (RPT), renal artery resistance index (RI). Review every 2 to 4 weeks until its’ birth. Review the kidney condition of the infant a week, a month, three months, six months after birth respectively, record the devopment of hydronephrosis and the ultrasonic parameters changes. Do univariate analysis on water kidneys, calculate the value of each kidney, assess the predictive value of single factor and multivariate are to prognostic hydronephrosis through specificity, sensitivity, Youden index evaluation, assess the prognostic evaluation of ultrasonography score to fetal hydronephrosis..Results The 65 fetus research objects are with total 94 fetal hydronephrosis:83 (88.3%)ones are rational living hydronephrosis,11 (11.7%) ones belong to pathological hydronephrosis.Univariate analysis result of fetal hydronephrosis (both are its’best cutoff value):①when APD≥1.3cm, the sensitivity, specificity and Youden in index in pathological diagnosis of hydronephrosis is 90.9%,84.3%, 0.752 respectively.②when renal parenchymal thickness≤0.4cm, the sensitivity, specificity and Youden in index in pathological diagnosis of hydronephrosis is 81.8%,87.9% and 0.697 respectively. ③when renal artery resistance index≥0.7, the sensitivity, specificity and Youden in index in pathological diagnosis of hydronephrosis is 90.9%,83.1% and 0.74 respectively.④the best cutoff value of using ultrasound score to evaluate the natuture of fetal hydronephrosis is 6 points. the sense itivity, specificity and Youden index were 90.9%,90.4%,0.813 respectively.Conclusio Use ultrasonography score to analyse aluaanterior-posterior diameter of renal pelvis, thickness of renal parenchyma, renal artery blood flow resistance index and kidney calices form these four factors with relative factor comprehensively. Assess the prognosis with the ultrasonography score is with high accuracy, which can provide guidance to clinic, contribute to our country’s prenatal and postnatal care.