The Diagnostic Accuracy of Antenatal Ultrasound in Posterior Urethral Valves
DOI:
https://doi.org/10.31580/pjmls.v4i4.2349Keywords:
Posterior urethral valves, cystourethrography, antenatal ultrasound, Diagnostic accuracyAbstract
Posterior urethral valves is the most common pediatric urological diagnosis in male children with worldwide estimated incidence of 1:5000 in alive male births, leading to end stage renal failure in next 10 years of life in half of these affected children.The aim of this study is to assess the diagnostic accuracy of Antenatal Ultrasound in posterior urethral valves, keeping postnatal Cystourethrography as gold standard.Record of 90 male new borns was revived retrospectively presenting with bilateral fetal hydronephrosis during this period. All these cases underwent at least one to four times detailed antenatal sonological examination by a trained sonologist of our center. Different antenatal sonological parameters were assessed in these patients to assess diagnostic accuracy of ultrasound in diagnosing posterior urethral valves. A total of 90 patients presenting with bilateral fetal hydronephrosis were included in the study. Average gestational age was 33 weeks±3.49.The diagnoses of ultrasound were subjected to Keyhole sign, Urinary Bladder dilatation, Thickened Urinary bladder wall and Oligohydramnios. The patients were labeled ashaving posterior urethral valves when at least two of the parameters were observed on ultrasound. Our study concluded and acknowledged that antenatal ultrasound is a reliable radiological tool in diagnosis of posterior urethral valves. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of antenatal ultrasound was established as 92.59%, 41.67%, 70.42%, 78.95%, and 72.22.% respectively. Among all sonologicalparameters , presence of distended and thick walled urinary bladder was the most frequently found finding.
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