Pregnancy Outcome And Chromosomal Analysis Of Fetal Renal Malformation Diagnosed By Prenatal Ultrasonography

Objective:To explore the pregnancy outcome and chromosomal analysis of prenatal ultrasound in predicting fetal renal malformation,provide corresponding prenatal guidance and diagnosis and treatment plan for pregnant women and clinicians.Methods:A total of 319 cases of fetal renal developmental malformations diagnosed by prenatal ultrasound from January 2017 to July 2021 in Qingdao University Affiliated Weihai Municipal Second Hospital were collected for systematic analysis to clarify the types of fetal renal developmental malformations,including renal pelvis separation(in this study,renal pelvis separation only include 5-10mm),hydronephrosis,duplication kidney,polycystic dysplastic kidney,hyperechoic kidney and other renal developmental malformations.According to whether the fetus is complicated with other organ malformations outside the kidney,it is classified into simple and complex,neonates born in some cases are followed up to 1 year of age.At the same time,amniocentesis was performed for pregnant women diagnosed with renal dysplasia by prenatal ultrasound to determine whether there were related chromosomal abnormalities,and statistical analysis was performed according to the results.Results:Among the 319 cases of renal dysplasia diagnosed by prenatal ultrasonography,122 cases of renal pelvis separation(5-10mm),119 cases of good pregnancy,3 cases of induced labor;66 cases of hydronephrosis,46 cases of good pregnancy,20 cases of induced labor;48 cases of duplication kidney,48 cases of good pregnancy,0 cases of induced labor;21 cases of polycystic dysplastic kidney,9 cases of good pregnancy,12 cases of induced labor;62 cases ofhyperechogenic kidney,40 cases of good pregnancy,22 cases of labor induction.A total of 147 cases underwent amniocentesis,22 cases of renal pelvis separation(5-10mm),1 case of chromosomal abnormality;45 cases of hydronephrosis,3 cases of chromosomal abnormality;20 cases of duplication kidney,0case of chromosomal abnormality;15 cases of polycystic dysplastic kidney,2 cases of chromosomal abnormality;45 cases ofhyperechogenic kidney and 15 cases of chromosomal abnormality.The results showed that there were significant differences in pregnancy outcomes among different types of renal malformations(P<0.05),and renal pelvis dissociation,duplication kidney has a higher rate of good pregnancy,while polycystic dysplastic kidney has a lower rate of good pregnancy.At the same time,the pregnancy outcome with other malformations was significantly different(P<0.05),and the good pregnancy rate of simple was higher than that of complicated.Conclusions:(1)Fetal renal pelvis separation(5-10 mm),hydronephrosis,and duplication kidneymostly exist independently,and renal pelvis separation(5-10 mm)and fetal duplication kidney have a higher rate of good pregnancy;polycystic dysplasia kidney has the lowest rate of good pregnancy.The pregnancy rate of simple fetal renal malformation is higher than that of complex fetal renal malformation;(2)Fetal renal pelvis separation(5-10mm),hydronephrosis,polycystic dysplastic kidney and duplication kidney have a lower rate of chromosomal abnormalities,while hyperechogenic kidney combined with chromosomal abnormalities is relatively high;(3)Prenatal identification of fetuses the type of renal malformation,combined with the results of chromosomal examination,determine whether to terminate the pregnancy as soon as possible.