Journal Article 当科で経験した両側胎児水腎症を呈した3例:娩出時期に関する考察を中心に
Three cases of bilateral congenital hydronephrosis ; Discussion about adequate timing of delivery

藤嶋, 明子  ,  佐藤, 朗  ,  小野寺, 洋平  ,  亀山, 沙恵子  ,  下田, 勇輝  ,  畠山, 佑子  ,  三浦, 広志  ,  田村, 啓成  ,  安達, 裕行  ,  寺田, 幸弘

43 ( 3/4 )  , pp.113 - 118 , 2017-03-31 , 秋田医学会
ISSN:03866106
NCID:AN00009294
Description
Fetal hydronephrosis is the most common feature of fetal urinary tract obstruction. However, perinatal management, such as prenatal intervention and adequate timing of delivery, has been controversial. We report 3 fetuses with bilateral congenital hydronephrosis. 【Case 1】A-36- year-old mother presented with multiple fetal renal cysts and severe oligohydramnios. A male infant was delivered at 35 weeks gestation. Posterior urethral valve (PUV) was diagnosed, and a transurethral valve ablation was performed 67 days after birth. 【Case 2】A-41-year-old mother presented with fetal ascites and severe oligohydramnios. Bladder rupture, with PUV, was suspected, and weekly drainage of the fetal ascites was performed. A male infant was delivered at 37 weeks gestation. Despite intensive therapy, he died 1 day after birth due to severe lung hypoplasia. 【Case 3】A-28-year-old mother presented with severe, bilateral fetal hydronephrosis, with an adequate volume of amniotic fluid. A male infant was delivered at 38 weeks gestation. Bilateral pyeloureteral junction stenosis was diagnosed and ureteropyeloplasty was recommended. These cases of fetal hydronephrosis are varied and the standard management is controversial. Therefore, multidisciplinary medical care, including the obstetrician, pediatric urologist, and neonatologist, is important for the management for fetal hydronephrosis.
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