Study On The Predictive Value Of APD Value And Ultrasound Score In Postnatal Fetal Surgery Of Simple Hydronephrosis

Objective:To investigate the clinical outcome of fetal simple hydronephrosis in the postpartum period,to predict the need for surgery,and to achieve accurate prenatal diagnosis and severity assessment.Methods:A retrospective analysis of 147 cases of children with simple hydronephrosis of the fetus with hydronephrosis in the urology,pediatrics,and obstetrics department of the Second Affiliated Hospital of Kunming Medical University from January 2017 to October 2019,aged from 0-8 years old,divided into 2 groups according to whether pelvic ureteroplasty was performed after birth:observation group(67 cases),surgery group(80 cases),and the time of prenatal B-ultrasound diagnosis of simple hydronephrosis(pregnancy Early,second trimester,third trimester)and APD values,PT values,and calamity status of each pregnancy and postnatal period(using this to calculate the ultrasound score).Results:1.The APD value and the ultrasound score value have predictive significance in the second trimester,the third trimester and the postnatal period whether the pelvic ureteroplasty is needed in children with simple hydronephrosis(P<0.001);2.The ultrasound score method The predictive value of the surgery in each period was better than the APD value,and the difference was statistically significant(P<0.05);3.The APD value for the second,third,and 48h postoperative births were 7.5mm and 13.5,respectively.mm,14.5mm,sensitivity 87%,92%,93%,specificity 86%,94%,92%,AUC value(area under the ROC curve)was 0.882,0.965,0.961.Ultrasound scores were 1.5,5.5,and 6.5 in the second,third,and 48h postoperative births,with a sensitivity of 88%,94%,and 96%,specificity of 93%,95%,and 98%,below the ROC curve.Areas 0.931,0.982,0.995.4.In the diagnosis of the combined indicators in the three periods,the indicators of the second trimester are not statistically significant(P>0.001);the APD value and the ultrasound score in the combined indicators for simple hydronephrosis The need for surgery after birth is predictive(P<0.001),and there is no statistical difference between the two(P>0.05).Conclusion:1.The APD value and ultrasound score of each pregnancy can be used as the criterion for judging whether or not to have surgery,which has important predictive value for the outcome of children with simple hydronephrosis.2,Ultrasound scoring as a comprehensive index,the predictive value of surgery is better than the commonly used APD.3.If judging the child's surgical probability based on various periods,the indicators in the second trimester are meaningless,and only the indicators in the third trimester+48h after birth can determine the possibility of surgery.4.For children with simple hydronephrosis found during pregnancy,regular B-ultrasound follow-up,close monitoring,and selective surgery after birth are the correct methods to avoid unnecessary termination of pregnancy.