Management of mild fetal pyelectasis: A comparative analysis

Objective. The purpose of this study was to compare 2 protocols for the antenatal management of isolated mild fetal pyelectasis and perform a cost analysis. Methods. A retrospective analysis of unilateral and bilateral mild fetal pyelectasis followed at our institution from 2003 to 2006 was conducted. Fetuses with additional congenital anomalies or aneuploidy were excluded, χ² analysis was used, and P < .05 was considered significant. Results. Two hundred forty-four cases were identified, of which the majority were male (75.4% versus 24.6%). Eighty-eight patients were reevaluated every 4 weeks (protocol 1). The remaining 156 patients were reevaluated once in the third trimester (protocol 2). The mean number of ultrasound examinations in protocol 1 was 3.24, at a cost of $1187, compared with protocol 2, at $798. Resolution occurred in 59%, stabilization in 29%, and progression in 12%. There were no cases of progression to severe pyelectasis or a need for in utero intervention in either group. Conclusions. Mild fetal pyelectasis can be managed with 1 additional third-trimester ultrasound examination without a compromise in patient care. Average cost savings were $389 per patient for protocol 2, suggesting a benefit from this protocol over protocol 1.