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19–22 APRIL, 2017, BARCELONA, SPAIN
S18-5 (P without presentation)
DECISION CURVE ANALYSIS OF PRENATAL ULTRASOUND
TO PREDICT POSTNATAL RENAL FUNCTION IN BOYS
WITH POSTERIOR URETHRAL VALVES
Luke HARPER
1
, Alice WAUBANT
2
, Yan LEFEVRE
3
, Eric DOBREMEZ
3
and Cyril FERDYNUS
2
1) CHU F Guyon, Pediatric Surgery, Saint-Denis De La Réunion, FRANCE - 2) CHU F Guyon, Saint-Denis
De La Reunion, FRANCE - 3) CHU Pellegrin-enfants, Bordeaux, FRANCE
PURPOSE
Prenatal management of boys with suspected posterior urethral valves depends on having a reliable
marker for postnatal long-term renal function. It has been suggested that presence of oligoamnios
could be predictive of postnatal function. We decided to evauate this hypothesis using Decision
Curve Analysis (DCA), which is a novel method for evaluating the clinical usefulness of diagnostic
tests.
MATERIAL AND METHODS
We analyzed retrospectively allboys born, in either of two university hospitals, with Posterior urethral
Valves between 2009 and 2012. We analyzed quantity of amniotic fluid on prenatal ultrasound and
the nadir creatinine. We divided the patients into two groups according to the nadir of their creatinine
using the cut-off value of 75µmol/L. We estimated the benefit of prenatal measurement of amniotic
fluid to determine postnatal renal function.
RESULTS
There were 51 children. Twelve presented prenatal oligoamnios. Thirty-one presented normal nadir
creatinine of which one had prenatal oligohydramnios, 13 presented a nadir creatinine between
35µmol/L and 75µmol/L of which 4 showed prenatal oligohydramnios, 7 presented a nadir creatinine
> 75µmol/L of which all had prenatal oligohydramnios.
CONCLUSIONS
DCA shows a net benefit of the measurement of prenatal quantity of amniotic fluid to determine
postnatal renal function.