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Пиелоэктазия матери и плода при беременности (обзор литературы)
Каптильный В.А, Успенская Ю.Б. Пиелоэктазия матери и плода при беременности (обзор литературы). Consilium Medicum. 2015; 17 (6): 41–44. DOI:10.26442/2075-1753_2015.6.41-44
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Kaptilnyy V.A., Uspenskaya Yu.B. Mother and fetus pyeloectasia during pregnancy. Consilium Medicum. 2015; 17 (6): 41–44. DOI: 10.26442/2075-1753_2015.6.41-44
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Аннотация
В обзоре представлено современное состояние проблемы дилатации чашечно-лоханочно-мочеточникового комплекса у матери и плода. Описаны морфологические и анатомические изменения, происходящие с мочевыводящими путями у беременных. Большое внимание уделено степеням дилатации собирательной системы почек у матери и плода, показана общая закономерность увеличения диаметра почечной лоханки у матерей при неосложненной беременности, продемонстрированы различные индексы резистентности в почечных артериях при обструктивной и необструктивной каликопиелоэктазии. Отражена значимость прицельного сканирования почек плода на протяжении всей беременности, показана ассоциация пиелоэктазии с анеуплоидией, в частности с трисомией по 21 паре хромосом и почечной патологией, подтверждаемой в постнатальном периоде. В обзоре отражена взаимосвязь фетальной пиелоэктазии и расширения чашечно-лоханочной системы матери, продемонстрирована важность ультразвукового скрининга.
Ключевые слова: пиелоэктазия при беременности, диагностика пиелоэктазии.
Ключевые слова: пиелоэктазия при беременности, диагностика пиелоэктазии.
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The review presents the current state of dilatation of the renal ureteropelvic complex of mothers and fetus. Morphological and anatomical changes that occur with urinary tract of pregnant women are described here. Much attention is given to the degrees of renal collecting system dilatation of mothers and fetus, general tendency is demonstrated for increasing the diameter of the renal pelvis with mothers who have uncomplicated pregnancies, various indices of resistance in renal arteries in case of obstruction and nonobstruction pyeloctasia are demonstrated here. The significance of fetus renal scan during pregnancy was shown here, they also show pyeloectasia association with aneuploidy, in particular, with trisomy in 21 pair of chromosomes and renal disease confirmed in the postnatal period. The review reflects correlation of fetal pyeloectasia and expansion of pyelocaliceal of mothers, the importance of ultrasound screening is demonstrated here.
Key words: pyelectasia during pregnancy, diagnosing pyeloectasia.
Key words: pyelectasia during pregnancy, diagnosing pyeloectasia.
Полный текст
Список литературы
1. Hodson CJ. Radiographic kidney size. In: Black DAK, ed. Renal disease. Oxford: Black-well Scientific Publications, 1968; p. 136.
2. Bailey RR, Rolleston GL. Kidney Length and ureteric dilatation in the puerperium. J Obstet Gynecol Br Commonw 1971; 78: 55.
3. Fainstat T. Ureteral dilatation in Pregnancy: a review. Obstet Gynecol Surv 1963; 18: 845.
4. Dure-Smith P. Pregnancy dilatation of the urinary tract. Radiology 1970; 96: 545.
5. Shulman A, Herlinger H. Urinary tract dilatation in pregnancy. Br J Radiol 1975; 48: 638.
6. Marchant DJ. Alterations in anatomy and function of the urinary during pregnancy. Clin Obstet Gynecol 1978; 21: 855.
7. Bergstrom H. Renographic evaluation of the renal excretion in hydronephrosis of pregnancy. Acta Obstet Gynecol Scand 1975; 54: 203.
8. Lentsch P, Schretzenmaier M, Dierkopf W et al. Dilatation of the upper urinary tract in pregnancy-incidence, severity and follow-up. A sonographic study. Urologe A 1987; 26 (3): 122–8.
9. Woo JS, Wan CW, Ma HK. Pregnancy hydronephrosis – a longitudinal ultrasonic evaluation. Aust N Z J Obstet Gynaecol. 1984; 24 (1): 9–13.
10. Fried AM, Woodring JH, Thompson DJ. Hydronephrosis of pregnancy: a prospective sequential study of the course of dilatation. J Ultrasound Med 1983; 2 (6): 255–9.
11. Tischendorf D. Sonographic studies of the dilatation of the kidney pelvis in pregnancy at term. Zentralbl Gynakol 1987; 109 (15): 952–5.
12. Erickson LM, Nicholson SF, Lewall DB, Frischke L. Ultrasound evaluation of hydronephrosis of pregnancy. J Clin Ultrasound 1979; 7 (2): 128–32.
13. Platt JF, Rubin JM, Ellis JH. Distinction between obstructive and nonobstructive pyelocaliectasis with duplex Doppler sonography. Am J Roentgenol 1989; 153–(5): 997–1000.
14. Snyder HM, Lebowitz RL, Coldny AH et al. Ureteropelvic junction obstruction in children. Urol Clin North An 1980; 7: 273–89.
15. Helin I, Persson PH. Prenatal diagnosis of urinary tract abnormalities by ultrasound. Pediatrics 1986; 78: 879–83.
16. Paduano L, Goglio L, Bembi B et al. Clinical outcome of fetal uropathy. 2. Sensitivity of echography for prenatal detection of obstructive pathology. J Urol 1991; 146: 1097–8.
17. Goncalves LF, Jeanty P, Piper JM et.al. The accuracy of prenatal ultrasonography in detecting congenital abnormalities. Am J Obstet Gynecol 1994; 171: 1606–12.
18. Benacerraf BR, Mandell J, Estroff JA et al/ Fetal pyelectasis: A possible association with Down syndrome. Obstet Gynecol 1990; 76: 58.
19. Chudleigh T. Mild pyelectasis. Prenat Diagn 2001; 21 (11): 936–41.
20. Coco C, Jeanty P. Isolated fetal pyelectasis and chromosomal abnormalities. Am J Obstet Gynecol 2005; 193 (3): 732–8.
21. Benacerraf BR, Neuberg D, Bromley B et al. Sonographicscoring index for prenatal detection of chromosomal abnormalities. J Ultrasound Med 1992; 11: 449.
22. Havutcu AE, Nikolopoulos G, Adinkra P, Lamont RF. The association between fetal pyelectasis on second trimester ultrasound scan and aneuploidy among 25,586 low risk unselected women. Prenat Diagn 2002; 22 (13): 1201–6.
23. Wickstrom E, Maizels M, Sabbagha RE et al. Isolated fetal pyelectasis: Assessment of risk for postnatal uropathy and Down syndrome. Ultrasound Obstet Gynecol 1996; 8: 236.
24. Corteville JE, Gray DL, Crane JP. Congenital hydronephrosis: Correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 1991; 165: 384.
25. Mandell J, Blyth BR, Peters CA et al. Structural genitourinary defects detected in utero. Radiology 1991; 178: 193.
26. Gunn TR, Mora JD, Pease P. Antenatal diagnosis of urinary tract abnormalities by ultrasonography after 28 weeks’ gestation: Incidence and outcome. Am J Obstet Gynecol 1995; 172: 479.
27. Arger PH, Coleman BG, Mintz MC et al. Routine fetal genitourinary tract screening. Radiology 1985; 156: 485.
28. Anderson N, Clautice-Engle T, Allan R et al. Detection of obstructive uropathy in the fetus: Predictive value of sonographic measurements of renal pelvic diameter at various gestational ages. Am J Roentgenol 1995; 64: 719.
29. Babcook СJ, Silvera M, Drake C, Levine D. Effect of Maternal Hydration on Mild Fetal Pyelectasis. American Institute of Ultrasound in Medicine. J Ultrasound Med 1998; 17: 539–44.
30. Robinson JN, Tice K, Kolm P, Abuhamad AZ. Effect of maternal hydration on fetal renal pyelectasis. Obstet Gynecol 1998; 92 (1): 137–41.
31. Ismaili K, Hall M, Avni FE. Management of isolated fetal dilatations of the kidney pelvis. Rev Med Brux 2003; 24 (1): 29–34.
32. Capello SA, Kogan BA, Giorgi LJ Jr, Kaufman RP Jr. Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol 2005; 174 (4 Pt 1): 1425–8.
33. Ouzounian JG, Castro MA, Fresquez M et al. Prognostic significance of antenatally detected fetal pyelectasis. Ultrasound Obstet Gynecol 1996; 7 (6): 424–8.
34. Podevin G, Levard G, Marechaud M et al. Post-natal diagnostic strategy of urinary tract malformations detected by prenatal screening. Arch Pediatr 1997; 4 (5): 411–5.
35. Graif M, Kessler A, Hart S et al. Renal pyelectasis in pregnancy: correlative evaluation of fetal and maternal collecting systems. Am J Obstet Gynecol 1992; 167 (5): 1304–6.
36. Devaussuzenet V, Dacher JN, Eurin D et al. Postnatal echography and cystography after prenatal diagnosis of minor dilatation of the kidney pelvis. Prospective study of 89 cases. J Radiol 1997; 78 (1): 27–31.
37. May Llanas ME, Moreira Echeverria A, Garcia Boente CV et al. Prenatal hydronephrosis: incidence, management and final diagnoses in 2003. An Pediatr (Barc) 2004; 61 (6): 499–501.
38. Gotoh H, Masuzaki H, Fukuda H et al. Detection and assessment of pyelectasis in the fetus: relationship to postnatal renal function.
39. Walsh G, Dubbins PA. Antenatal renal pelvis dilatation: a predictor of vesicoureteral reflux? AJR Am J Roentgenol 1996; 167 (4): 897–900.
2. Bailey RR, Rolleston GL. Kidney Length and ureteric dilatation in the puerperium. J Obstet Gynecol Br Commonw 1971; 78: 55.
3. Fainstat T. Ureteral dilatation in Pregnancy: a review. Obstet Gynecol Surv 1963; 18: 845.
4. Dure-Smith P. Pregnancy dilatation of the urinary tract. Radiology 1970; 96: 545.
5. Shulman A, Herlinger H. Urinary tract dilatation in pregnancy. Br J Radiol 1975; 48: 638.
6. Marchant DJ. Alterations in anatomy and function of the urinary during pregnancy. Clin Obstet Gynecol 1978; 21: 855.
7. Bergstrom H. Renographic evaluation of the renal excretion in hydronephrosis of pregnancy. Acta Obstet Gynecol Scand 1975; 54: 203.
8. Lentsch P, Schretzenmaier M, Dierkopf W et al. Dilatation of the upper urinary tract in pregnancy-incidence, severity and follow-up. A sonographic study. Urologe A 1987; 26 (3): 122–8.
9. Woo JS, Wan CW, Ma HK. Pregnancy hydronephrosis – a longitudinal ultrasonic evaluation. Aust N Z J Obstet Gynaecol. 1984; 24 (1): 9–13.
10. Fried AM, Woodring JH, Thompson DJ. Hydronephrosis of pregnancy: a prospective sequential study of the course of dilatation. J Ultrasound Med 1983; 2 (6): 255–9.
11. Tischendorf D. Sonographic studies of the dilatation of the kidney pelvis in pregnancy at term. Zentralbl Gynakol 1987; 109 (15): 952–5.
12. Erickson LM, Nicholson SF, Lewall DB, Frischke L. Ultrasound evaluation of hydronephrosis of pregnancy. J Clin Ultrasound 1979; 7 (2): 128–32.
13. Platt JF, Rubin JM, Ellis JH. Distinction between obstructive and nonobstructive pyelocaliectasis with duplex Doppler sonography. Am J Roentgenol 1989; 153–(5): 997–1000.
14. Snyder HM, Lebowitz RL, Coldny AH et al. Ureteropelvic junction obstruction in children. Urol Clin North An 1980; 7: 273–89.
15. Helin I, Persson PH. Prenatal diagnosis of urinary tract abnormalities by ultrasound. Pediatrics 1986; 78: 879–83.
16. Paduano L, Goglio L, Bembi B et al. Clinical outcome of fetal uropathy. 2. Sensitivity of echography for prenatal detection of obstructive pathology. J Urol 1991; 146: 1097–8.
17. Goncalves LF, Jeanty P, Piper JM et.al. The accuracy of prenatal ultrasonography in detecting congenital abnormalities. Am J Obstet Gynecol 1994; 171: 1606–12.
18. Benacerraf BR, Mandell J, Estroff JA et al/ Fetal pyelectasis: A possible association with Down syndrome. Obstet Gynecol 1990; 76: 58.
19. Chudleigh T. Mild pyelectasis. Prenat Diagn 2001; 21 (11): 936–41.
20. Coco C, Jeanty P. Isolated fetal pyelectasis and chromosomal abnormalities. Am J Obstet Gynecol 2005; 193 (3): 732–8.
21. Benacerraf BR, Neuberg D, Bromley B et al. Sonographicscoring index for prenatal detection of chromosomal abnormalities. J Ultrasound Med 1992; 11: 449.
22. Havutcu AE, Nikolopoulos G, Adinkra P, Lamont RF. The association between fetal pyelectasis on second trimester ultrasound scan and aneuploidy among 25,586 low risk unselected women. Prenat Diagn 2002; 22 (13): 1201–6.
23. Wickstrom E, Maizels M, Sabbagha RE et al. Isolated fetal pyelectasis: Assessment of risk for postnatal uropathy and Down syndrome. Ultrasound Obstet Gynecol 1996; 8: 236.
24. Corteville JE, Gray DL, Crane JP. Congenital hydronephrosis: Correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 1991; 165: 384.
25. Mandell J, Blyth BR, Peters CA et al. Structural genitourinary defects detected in utero. Radiology 1991; 178: 193.
26. Gunn TR, Mora JD, Pease P. Antenatal diagnosis of urinary tract abnormalities by ultrasonography after 28 weeks’ gestation: Incidence and outcome. Am J Obstet Gynecol 1995; 172: 479.
27. Arger PH, Coleman BG, Mintz MC et al. Routine fetal genitourinary tract screening. Radiology 1985; 156: 485.
28. Anderson N, Clautice-Engle T, Allan R et al. Detection of obstructive uropathy in the fetus: Predictive value of sonographic measurements of renal pelvic diameter at various gestational ages. Am J Roentgenol 1995; 64: 719.
29. Babcook СJ, Silvera M, Drake C, Levine D. Effect of Maternal Hydration on Mild Fetal Pyelectasis. American Institute of Ultrasound in Medicine. J Ultrasound Med 1998; 17: 539–44.
30. Robinson JN, Tice K, Kolm P, Abuhamad AZ. Effect of maternal hydration on fetal renal pyelectasis. Obstet Gynecol 1998; 92 (1): 137–41.
31. Ismaili K, Hall M, Avni FE. Management of isolated fetal dilatations of the kidney pelvis. Rev Med Brux 2003; 24 (1): 29–34.
32. Capello SA, Kogan BA, Giorgi LJ Jr, Kaufman RP Jr. Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol 2005; 174 (4 Pt 1): 1425–8.
33. Ouzounian JG, Castro MA, Fresquez M et al. Prognostic significance of antenatally detected fetal pyelectasis. Ultrasound Obstet Gynecol 1996; 7 (6): 424–8.
34. Podevin G, Levard G, Marechaud M et al. Post-natal diagnostic strategy of urinary tract malformations detected by prenatal screening. Arch Pediatr 1997; 4 (5): 411–5.
35. Graif M, Kessler A, Hart S et al. Renal pyelectasis in pregnancy: correlative evaluation of fetal and maternal collecting systems. Am J Obstet Gynecol 1992; 167 (5): 1304–6.
36. Devaussuzenet V, Dacher JN, Eurin D et al. Postnatal echography and cystography after prenatal diagnosis of minor dilatation of the kidney pelvis. Prospective study of 89 cases. J Radiol 1997; 78 (1): 27–31.
37. May Llanas ME, Moreira Echeverria A, Garcia Boente CV et al. Prenatal hydronephrosis: incidence, management and final diagnoses in 2003. An Pediatr (Barc) 2004; 61 (6): 499–501.
38. Gotoh H, Masuzaki H, Fukuda H et al. Detection and assessment of pyelectasis in the fetus: relationship to postnatal renal function.
39. Walsh G, Dubbins PA. Antenatal renal pelvis dilatation: a predictor of vesicoureteral reflux? AJR Am J Roentgenol 1996; 167 (4): 897–900.
________________________________________________
1. Hodson CJ. Radiographic kidney size. In: Black DAK, ed. Renal disease. Oxford: Black-well Scientific Publications, 1968; p. 136.
2. Bailey RR, Rolleston GL. Kidney Length and ureteric dilatation in the puerperium. J Obstet Gynecol Br Commonw 1971; 78: 55.
3. Fainstat T. Ureteral dilatation in Pregnancy: a review. Obstet Gynecol Surv 1963; 18: 845.
4. Dure-Smith P. Pregnancy dilatation of the urinary tract. Radiology 1970; 96: 545.
5. Shulman A, Herlinger H. Urinary tract dilatation in pregnancy. Br J Radiol 1975; 48: 638.
6. Marchant DJ. Alterations in anatomy and function of the urinary during pregnancy. Clin Obstet Gynecol 1978; 21: 855.
7. Bergstrom H. Renographic evaluation of the renal excretion in hydronephrosis of pregnancy. Acta Obstet Gynecol Scand 1975; 54: 203.
8. Lentsch P, Schretzenmaier M, Dierkopf W et al. Dilatation of the upper urinary tract in pregnancy-incidence, severity and follow-up. A sonographic study. Urologe A 1987; 26 (3): 122–8.
9. Woo JS, Wan CW, Ma HK. Pregnancy hydronephrosis – a longitudinal ultrasonic evaluation. Aust N Z J Obstet Gynaecol. 1984; 24 (1): 9–13.
10. Fried AM, Woodring JH, Thompson DJ. Hydronephrosis of pregnancy: a prospective sequential study of the course of dilatation. J Ultrasound Med 1983; 2 (6): 255–9.
11. Tischendorf D. Sonographic studies of the dilatation of the kidney pelvis in pregnancy at term. Zentralbl Gynakol 1987; 109 (15): 952–5.
12. Erickson LM, Nicholson SF, Lewall DB, Frischke L. Ultrasound evaluation of hydronephrosis of pregnancy. J Clin Ultrasound 1979; 7 (2): 128–32.
13. Platt JF, Rubin JM, Ellis JH. Distinction between obstructive and nonobstructive pyelocaliectasis with duplex Doppler sonography. Am J Roentgenol 1989; 153–(5): 997–1000.
14. Snyder HM, Lebowitz RL, Coldny AH et al. Ureteropelvic junction obstruction in children. Urol Clin North An 1980; 7: 273–89.
15. Helin I, Persson PH. Prenatal diagnosis of urinary tract abnormalities by ultrasound. Pediatrics 1986; 78: 879–83.
16. Paduano L, Goglio L, Bembi B et al. Clinical outcome of fetal uropathy. 2. Sensitivity of echography for prenatal detection of obstructive pathology. J Urol 1991; 146: 1097–8.
17. Goncalves LF, Jeanty P, Piper JM et.al. The accuracy of prenatal ultrasonography in detecting congenital abnormalities. Am J Obstet Gynecol 1994; 171: 1606–12.
18. Benacerraf BR, Mandell J, Estroff JA et al/ Fetal pyelectasis: A possible association with Down syndrome. Obstet Gynecol 1990; 76: 58.
19. Chudleigh T. Mild pyelectasis. Prenat Diagn 2001; 21 (11): 936–41.
20. Coco C, Jeanty P. Isolated fetal pyelectasis and chromosomal abnormalities. Am J Obstet Gynecol 2005; 193 (3): 732–8.
21. Benacerraf BR, Neuberg D, Bromley B et al. Sonographicscoring index for prenatal detection of chromosomal abnormalities. J Ultrasound Med 1992; 11: 449.
22. Havutcu AE, Nikolopoulos G, Adinkra P, Lamont RF. The association between fetal pyelectasis on second trimester ultrasound scan and aneuploidy among 25,586 low risk unselected women. Prenat Diagn 2002; 22 (13): 1201–6.
23. Wickstrom E, Maizels M, Sabbagha RE et al. Isolated fetal pyelectasis: Assessment of risk for postnatal uropathy and Down syndrome. Ultrasound Obstet Gynecol 1996; 8: 236.
24. Corteville JE, Gray DL, Crane JP. Congenital hydronephrosis: Correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 1991; 165: 384.
25. Mandell J, Blyth BR, Peters CA et al. Structural genitourinary defects detected in utero. Radiology 1991; 178: 193.
26. Gunn TR, Mora JD, Pease P. Antenatal diagnosis of urinary tract abnormalities by ultrasonography after 28 weeks’ gestation: Incidence and outcome. Am J Obstet Gynecol 1995; 172: 479.
27. Arger PH, Coleman BG, Mintz MC et al. Routine fetal genitourinary tract screening. Radiology 1985; 156: 485.
28. Anderson N, Clautice-Engle T, Allan R et al. Detection of obstructive uropathy in the fetus: Predictive value of sonographic measurements of renal pelvic diameter at various gestational ages. Am J Roentgenol 1995; 64: 719.
29. Babcook СJ, Silvera M, Drake C, Levine D. Effect of Maternal Hydration on Mild Fetal Pyelectasis. American Institute of Ultrasound in Medicine. J Ultrasound Med 1998; 17: 539–44.
30. Robinson JN, Tice K, Kolm P, Abuhamad AZ. Effect of maternal hydration on fetal renal pyelectasis. Obstet Gynecol 1998; 92 (1): 137–41.
31. Ismaili K, Hall M, Avni FE. Management of isolated fetal dilatations of the kidney pelvis. Rev Med Brux 2003; 24 (1): 29–34.
32. Capello SA, Kogan BA, Giorgi LJ Jr, Kaufman RP Jr. Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol 2005; 174 (4 Pt 1): 1425–8.
33. Ouzounian JG, Castro MA, Fresquez M et al. Prognostic significance of antenatally detected fetal pyelectasis. Ultrasound Obstet Gynecol 1996; 7 (6): 424–8.
34. Podevin G, Levard G, Marechaud M et al. Post-natal diagnostic strategy of urinary tract malformations detected by prenatal screening. Arch Pediatr 1997; 4 (5): 411–5.
35. Graif M, Kessler A, Hart S et al. Renal pyelectasis in pregnancy: correlative evaluation of fetal and maternal collecting systems. Am J Obstet Gynecol 1992; 167 (5): 1304–6.
36. Devaussuzenet V, Dacher JN, Eurin D et al. Postnatal echography and cystography after prenatal diagnosis of minor dilatation of the kidney pelvis. Prospective study of 89 cases. J Radiol 1997; 78 (1): 27–31.
37. May Llanas ME, Moreira Echeverria A, Garcia Boente CV et al. Prenatal hydronephrosis: incidence, management and final diagnoses in 2003. An Pediatr (Barc) 2004; 61 (6): 499–501.
38. Gotoh H, Masuzaki H, Fukuda H et al. Detection and assessment of pyelectasis in the fetus: relationship to postnatal renal function.
39. Walsh G, Dubbins PA. Antenatal renal pelvis dilatation: a predictor of vesicoureteral reflux? AJR Am J Roentgenol 1996; 167 (4): 897–900.
Авторы
В.А.Каптильный*, Ю.Б.Успенская
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*1mgmu@mail.ru
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*1mgmu@mail.ru
________________________________________________
V.A.Kaptilnyy*, Yu.B.Uspenskaya
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*1mgmu@mail.ru
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*1mgmu@mail.ru
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