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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1539-1543 • 0278-4297

Management of Mild Fetal Pyelectasis

A Comparative Analysis

Yasuko Yamamura, MD, Jessica P. Swartout, MD, Elisabeth A. Anderson, RDMS, Carla M. Knapp, RDMS and Kirk D. Ramin, MD

Department of Obstetrics, Gynecology, and Women’s Health, University of Minnesota, Minneapolis, Minnesota USA.

Address correspondence to Yasuko Yamamura, MD, Department of Obstetrics, Gynecology, and Women’s Health, Division of Maternal-Fetal Medicine, University of Minnesota, 420 Delaware St, SE, MMC 395, Minneapolis, MN 55455 USA. E-mail: yama0095{at}umn.edu

Objective. The purpose of this study was to compare 2 protocols for the antenatal management of isolated mild fetal pyelectasis and perform a cost analysis. Methods. A retrospective analysis of unilateral and bilateral mild fetal pyelectasis followed at our institution from 2003 to 2006 was conducted. Fetuses with additional congenital anomalies or aneuploidy were excluded. {chi}2 analysis was used, and P < .05 was considered significant. Results. Two hundred forty-four cases were identified, of which the majority were male (75.4% versus 24.6%). Eighty-eight patients were reevaluated every 4 weeks (protocol 1). The remaining 156 patients were reevaluated once in the third trimester (protocol 2). The mean number of ultrasound examinations in protocol 1 was 3.24, at a cost of $1187, compared with protocol 2, at $798. Resolution occurred in 59%, stabilization in 29%, and progression in 12%. There were no cases of progression to severe pyelectasis or a need for in utero intervention in either group. Conclusions. Mild fetal pyelectasis can be managed with 1 additional third-trimester ultrasound examination without a compromise in patient care. Average cost savings were $389 per patient for protocol 2, suggesting a benefit from this protocol over protocol 1.

Key Words: fetal pyelectasis • renal pelvis • ultrasonography • ultrasound

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.