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El control posnatal del feto con pielectasia ha sido objeto de controversia en la bibliografía reciente. La definición de pielectasia, la necesidad de estudiar o no a todos estos recién nacidos con el objetivo teórico de prevenir la nefropatía por reflujo y las infecciones urinarias, qué exploraciones hacerles y cuándo (ecografía posnatal, cistografía sistemática, estudios isotópicos), y si es necesario someterlos o no a profilaxis antibiótica, son aspectos que no están suficientemente aclarados. Tampoco la relación entre pielectasia prenatal, reflujo vesicorrenal e infección parece lineal.
Este artículo intenta ordenar las controversias actualmente existentes al respecto, comentando finalmente el papel de las alteraciones genéticas en el desarrollo de los distintos tipos de nefropatía y malformaciones renales.
Palabras clave:
Pielectasia fetal
Hidronefrosis prenatal
Recién nacido
Diagnóstico prenatal
Reflujo vesicoureteral
Postnatal follow-up of fetal pyelectasis is a controversial topic in recent literature.
Questions such as the definition of pyelectasis, whether these neonates should be selected for postnatal study in an attempt to prevent reflux nephropathy and urinary tract infections, which complementary investigations (postnatal ultrasonography, cystourethrography, isotopic studies) should be performed and when, and whether these neonates should be administered antibiotic prophylaxis are unresolved issues. In addition, the relationship between prenatal pyelectasis, vesicoureteral reflux and infections is not at present clear.
In this article, we try to review and order the present controversies, and briefly introduce the role of genetic aspects in the origin of different forms of nephropathy and renal malformations.
Key words:
Fetal pyelectasis
Congenital hydronephrosis
Newborn
Prenatal diagnosis
Vesicoureteral reflux
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