CURRENT APPROACHES TO DIAGNOSIS AND PREGNANCY MANAGEMENT TACTICS IN CONGENITAL OBSTRUCTIVE UROPATHIES IN THE FETUS
Objective. To define the value of prenatal echography in the detection of congenital obstructive uropathies in the fetus and pregnancy management tactics. Material and methods. One hundred and nine cases of obstructive urinary tract abnormalities found in the antenatal period were retrospectively analyzed. Echographic studies were performed antenatally and postnatally. The complex neonatal examination included the following studies: clinical blood analysis, biochemical blood and urine analysis, bacteriological urinalysis, echography, nephroscintigraphy, and contrast-enhanced magnetic resonance imaging of the urinary tract. All cases were divided into 4 groups according to the degree of urinary tract obstruction, as recommended by the Society of Neonatal Urologists, and analyzed in detail. Results. Thirty-three (30.3%) neonatal infants were found to have spontaneous hydronephrosis resolution with insignificant pyelocaliceal complex dilation in the first month after birth. The mean values of the anteroposterior dimensions of the renal pelvis (APDRP) significantly differed in 4 comparison groups. Retrospective analysis showed that surgical interventions were more frequently performed in infants whose APDRP was more than 19 mm at the echography carried out in the third trimester of pregnancy.