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1.To determine the proportion of renal and uterer diseases in newborns at NHOG.

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STUDY ON PROPORTION AND DIAGNOSIS OF RENAL AND UTERER MALFORMATIONS BEFORE AND

AFTER BIRTH AT NATIONAL HOSPITAL OF OBSTETRICS AND GYNEACOLOGY

Assoc. Prof. TRAN NGOC BICH, MD, PhD TRAN DUC TU, MD, MSc

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BACKGROUND

 Renal and uterer malformation (RUM) in newborns is a group of abnormalities in term of functions, structures and morphology related to kidney and uterer.

 Study of Trần Đình Long et al has shown that the rate of RUD in newborn is 0,98%

 Trần Ngọc Bích et al (2013) indicated that the rate of RUD is 11,5% among all newborn disorders

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 F.Boussion (2011) has shown that the rate of RUM took about 20-30% all abnormalities, rank the 2nd after central nervous system disorders, and prenatal detection rate is about 80%.

 Prenatal screening by ultrasound and postnatal diagnosis help physicians to manage those conditions to avoid newborn mortality.

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OBJECTIVES

1.To determine the proportion of renal and uterer diseases in newborns at NHOG.

2.To compare diagnosis of those diseases

before and after birth.

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METHODOLOGY

Materials:

 All newborns diagnosed with renal and uterer malformations, and were born in NHOG from January 2014 to July, 2015.

o Inclusion criteria

 All newborns were delivered at NHOG diagnosed with renal and uterer malformations.

o Exclusion criteria

 Newborn death within first 24 hours

o Study design: propective study o Sample size: Convinient sample

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RESULTS AND DISCUSSIONS

Among 76 patients, 100 RUM were detected prenatally.

After birth, among 70 patients, 87 RUM were diagnosed.

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The rate of renal and uterer malformations

 The rate of renal and uterer malformations at NHOG was 0,2% (70/35351).

 Male: 0,24% (46/19166)

 Female: 0,15% (24/16185)

Agnieska Lukomaska và cs (2012) 0,17%

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Distribution of gender-position of kidney-uterer

Ratio of male/female with RUD: 1,92/1.

RUD left/right: 1,59/1.

Bilateral disorder of kidney: 18,57%.

Halek J et al (2010) male/female: 1,6/1, Dias T et al (2014) male/female: 2/1 Di Renzo (2013) left/right: 1,7/1

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Gestational age N %

Preterm birth (<37 week) 5 6,6%

Term birth (37 to 42 week) 71 93,4%

Distribution of gestational age at birth

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RUM detected by prenatal ultrasound

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Malformations n %

Kidney 23 26,43%

Uterer 55 63,2%

Both 9 10,37 %

Total 87 100%

Renal and uterer malformations diagnosed after birth

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Prenatal diagnosis

Postnatal diagnosis

Correct diagnosis

Hydronephrosis 65 43 66,15%

Megauretere 4 7 57,14%

Utererocele 4 5 80%

Uterer-renal duplex 5 9 55,55%

renal displasia 0 2 0

Renal dystrophy 7 7 100%

Renal cyst 11 10 90,09%

Renal atrophy 4 4 100%

Total 100 87

Comparision of RUM before and after birth

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N

Period

≤ 1 month 2-12 months 13-18 months

Hydronephrosis 7 2 4 1

renal-uterer duplex +

utererocele 6 1 3 2

Megauterer 4 1 2 1

Renal displasia 1 0 0 1

Renal cyst 1 0 1 0

Total 19 4 10 5

Newborns received surgical operation during follow-up

Surgical treatment: 27,14% (19/70) Koff SA (2000) 22%

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CONCLUSIONS

In our study, the proportion of renal uterer malformations was

0,2% in all newborn in researched period. Among those detected diseases, hydronephrosis was common in population.

Prenatal ultrasound is valuable in detecting RUM. To compare before and after birth diagnosis, ultrasound detection rate was 87%.

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