Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)

Hiep T Nguyen; Carol B Benson; Bryann Bromley; Jeffrey B Campbell; Jeanne Chow; Beverly Coleman; Christopher Cooper; Jude Crino; Kassa Darge; C.D. Anthony Herndon; Anthony O Odibo; Michael J.G Somers; Deborah R Stein

doi:10.1016/j.jpurol.2014.10.002

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Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)

Journal article

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Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)

Hiep T Nguyen, Carol B Benson, Bryann Bromley, Jeffrey B Campbell, Jeanne Chow, Beverly Coleman, Christopher Cooper, Jude Crino, Kassa Darge, C.D. Anthony Herndon, …

Journal of pediatric urology, Vol.10(6), pp.982-998

12/2014

DOI: 10.1016/j.jpurol.2014.10.002

PMID: 25435247

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Abstract

Urinary tract (UT) dilation is sonographically identified in 1–2% of fetuses and reflects a spectrum of possible uropathies. There is significant variability in the clinical management of individuals with prenatal UT dilation that stems from a paucity of evidence-based information correlating the severity of prenatal UT dilation to postnatal urological pathologies. The lack of correlation between prenatal and postnatal US findings and final urologic diagnosis has been problematic, in large measure because of a lack of consensus and uniformity in defining and classifying UT dilation. Consequently, there is a need for a unified classification system with an accepted standard terminology for the diagnosis and management of prenatal and postnatal UT dilation. A consensus meeting was convened on March 14–15, 2014, in Linthicum, Maryland, USA to propose: 1) a unified description of UT dilation that could be applied both prenatally and postnatally; and 2) a standardized scheme for the perinatal evaluation of these patients based on sonographic criteria (i.e. the classification system). The participating societies included American College of Radiology, the American Institute of Ultrasound in Medicine, the American Society of Pediatric Nephrology, the Society for Fetal Urology, the Society for Maternal-Fetal Medicine, the Society for Pediatric Urology, the Society for Pediatric Radiology and the Society of Radiologists in Ultrasounds. The recommendations proposed in this consensus statement are based on a detailed analysis of the current literature and expert opinion representing common clinical practice. The proposed UTD Classification System (and hence the severity of the UT dilation) is based on six categories in US findings: 1) anterior-posterior renal pelvic diameter (APRPD); 2) calyceal dilation; 3) renal parenchymal thickness; 4) renal parenchymal appearance; 5) bladder abnormalities; and 6) ureteral abnormalities. The classification system is stratified based on gestational age and whether the UT dilation is detected prenatally or postnatally. The panel also proposed a follow-up scheme based on the UTD classification. The proposed grading classification system will require extensive evaluation to assess its utility in predicting clinical outcomes. Currently, the grading system is correlated with the risk of postnatal uropathies. Future research will help to further refine the classification system to one that correlates with other clinical outcomes such as the need for surgical intervention or renal function.

Ultrasonography

Prenatal

Evaluation

Postnatal

Classification

Hydronephrosis

Details

Title: Subtitle: Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)
Creators: Hiep T Nguyen - Society for Fetal Urology (SFU), Linthicum, MD, USA
Carol B Benson - American College of Radiology (ACR), Reston, VA, USA
Bryann Bromley - American Institute of Ultrasound in Medicine (AIUM), Laurel, MD, USA
Jeffrey B Campbell - Society for Fetal Urology (SFU), Linthicum, MD, USA
Jeanne Chow - Society for Pediatric Radiology (SPR), Reston, VA, USA
Beverly Coleman - American College of Radiology (ACR), Reston, VA, USA
Christopher Cooper - Society for Fetal Urology (SFU), Linthicum, MD, USA
Jude Crino - Society for Maternal-Fetal Medicine (SMFM), Washington, D.C., USA
Kassa Darge - Society for Pediatric Radiology (SPR), Reston, VA, USA
C.D. Anthony Herndon - Society for Fetal Urology (SFU), Linthicum, MD, USA
Anthony O Odibo - Society for Maternal-Fetal Medicine (SMFM), Washington, D.C., USA
Michael J.G Somers - American Society of Pediatric Nephrology (ASPN), The Woodlands, TX, USA
Deborah R Stein - American Society of Pediatric Nephrology (ASPN), The Woodlands, TX, USA
Resource Type: Journal article
Publication Details: Journal of pediatric urology, Vol.10(6), pp.982-998
Publisher: Elsevier Ltd
DOI: 10.1016/j.jpurol.2014.10.002
PMID: 25435247
ISSN: 1477-5131
eISSN: 1873-4898
Grant note: DOI: 10.13039/100001466, name: American Urological Association
Language: English
Date published: 12/2014
Academic Unit: Stead Family Department of Pediatrics; Urology; Medicine Administration
Record Identifier: 9984051765002771

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