The Value Of Ultrasonography In The Evaluation Of Developmental Progress Of Fetal Hydronephrosis

Objective: through the analysis on the clinical data of 54 cases of fetal hydronephrosis,respectively discusses the single ultrasonic indicators renal pelvis diameter,thickness of renal parenchyma and renal artery resistance index and multi-factor ultrasonic evaluation method in the outcome of the development of kidney seeper evaluation value,looking for a kind of effective assessment outcome of fetal hydronephrosis development method,for clinical provides reliable and comprehensive information,to guide the choice of prenatal intervention and postnatal treatments.Methods: From April 2016 to December 2017,pregnant women with prenatal ultrasound examination performed at the Department of Ultrasound,Affiliated Hospital of Yan'an University,had single menstrual and late pregnancy with a regular menstrual cycle and clear menstrual cycle without serious pregnancy complications.Weeks?28 weeks and fetal renal anteroposterior diameter of?1cm were satisfied.Routine obstetric ultrasonography was performed on selected pregnant women to record the ultrasonic evaluation indicators such as pelvic anteroposterior diameter(APD),renal parenchyma thickness(RPT),and renal artery flow resistance index(RI)of each hydronephrosis fetus.According to the severity of hydronephrosis,the three parameters were separately assigned to ultrasound(0-3 points),and the total ultrasound score of each kidney was accumulated.When the cumulative statistics were taken,the most severe ultrasound examination was adopted.The fetus with hydronephrosis is reviewed every 4-6 weeks until birth.The hydronephrosis was reviewed every 3 months after birth,and the developmental changes and changes in ultrasound parameters were recorded.According to multiple postpartum ultrasound examinations and plain CT scans,MRU,infant urography,and surgical pathology results,the hydronephrosis was defined as two groups:physiological hydronephrosis and pathological hydronephrosis.The APD,RPT,RI,and ultrasound scores of hydronephrosis were statistically analyzed in both groups,and the value of each single index and ultrasound scoring method in assessing the development of fetal hydronephrosis was explored.Results:(1)There were 54 cases of hydronephrosis and 10 cases of hydronephrosis in 54 cases of prenatal ultrasound diagnosis.After birth,there were 52 cases of physiological hydronephrosis and 12 cases of pathological hydronephrosis.The water is approximately4.3 times that of pathological hydronephrosis,and it can be seen that prenatal diagnosis of hydronephrosis is mostly physiological.(2)We analyzed the diagnostic value of single ultrasound parameters for pathological hydronephrosis and found that when APD?15mm,the accuracy of diagnosing pathologic hydronephrosis was highest,with a sensitivity,specificity,and a Yoden index of 66.7%,respectively.92.3%,0.590;when the RPT<5mm,the accuracy of diagnosis of pathological hydronephrosis was highest,the sensitivity,specificity,aboutden index were 83.3%,82.7%,0.660;when RI ? 0.9 The accuracy of diagnosing pathological hydronephrosis was the highest,with sensitivity,specificity,and Yoden index of 83.3%,84.6%,and 0.679,respectively.(3)The optimal cut-off value of the fetal hydronephrosis was 6 points in the evaluation of ultrasound scores.The sensitivity,specificity,and the Yoden index for the diagnosis of pathologic hydronephrosis were 91.7%,90.4%,and 0.821,respectively.(4)Compared with single index evaluation of the development of hydronephrosis,the ultrasound scoring method has the highest value for the pathological hydronephrosis,and the RI and RPT cutoffs have the same value for the assessment of pathological hydronephrosis,and the APD cutoff has a prognostic value.The lowest assessment value.Conclusion: Ultrasound scoring method can quantitatively analyze the factors closely related to the level of fetal hydronephrosis,can effectively distinguish the nature of fetal hydronephrosis,and more accurately assess its development.Ultrasound scoringis a newquantitative method for assessing the prognosis of fetal hydronephrosis,providing more comprehensive and accurate clinical information to guide prenatal intervention and postpartum treatment.It is worthy of being recognized by clinical doctors and widely used.