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Marc Alexander

Publications and source records attributed to Marc Alexander.

4 recordsLinked to original sources
PubMed2005

Insights into the pathogenesis and natural history of fetuses with renal pelvis dilatation.

Fetal renal pelvis dilatation is a frequent abnormality that has been observed in 4.5% of pregnancies. The majority of these cases have a tendency to resolve during infancy. Nevertheless, fetal renal pelvis dilatation may be due to significant structural abnormalities such as pelvi-ureteric junction stenosis or vesico-ureteral reflux that may adversely affect renal function or cause urinary infection or sepsis. This review article aims to summarize the data regarding fetal renal pelvis dilatation and to analyze controversial attitudes in the light of the various lines of practice, and to present rational antenatal and postnatal investigation strategy.

Dilatation, Pathologic↗
PubMed2005

Routine voiding cystourethrography is of no value in neonates with unilateral multicystic dysplastic kidney.

OBJECTIVES: To determine if two successive ultrasound examinations could rule out the presence of clinically significant contralateral anomalies in neonates with multicystic dysplastic kidney (MCDK), thereby avoiding unnecessary voiding cystourethrography (VCUG). STUDY DESIGN: We followed 76 newborn infants with antenatally discovered MCDK. Two successive neonatal renal ultrasound examinations were performed, one within the first week and one at around 1 month of life. VCUG and isotopic studies were performed in all infants. RESULTS: Urologic anomalies of the contralateral kidney were present in 19 of 76 children (25%): vesicoureteral reflux (VUR) in 16 (21%), ureteropelvic junction obstruction in 2 (3%), and renal duplex kidney in 1 (1%). Sixty-one infants (80% of total) had normal contralateral urinary tract on the 2 successive neonatal renal ultrasound scans. Among them, 4 of 61 (7%) infants presented with low-grade VUR on VCUG that had resolved spontaneously before 2 years of age. The sensitivity, specificity, positive predictive value, and negative predictive value of two successive ultrasound scans in the neonatal period to predict contralateral urological anomalies on VCUG were 75%, 95%, 80%, and 93%, respectively. CONCLUSIONS: In infants with antenatally diagnosed MCDK, two successive normal neonatal renal ultrasound scans will rule out clinically significant contralateral anomalies, thereby rendering the need for a neonatal VCUG unnecessary.

Female↗