ULTRASONIC INDICATORS OF URETERAL REFLUX IN THE NEWBORN

There is controversy over the value of ultrasonic screening for detect ion of vesicoureteric reflux (VUR) in babies. We scanned 300 newborn b abies and identified 53 with a dilated renal pelvis or other minor abn ormalities. Eventually, 9 of these were investigated by voiding cystou rethrography and 3 (5 kidneys) proved to have VUR exceeding grade II, In 3 babies the reason for cystourethrography was persistent renal pel vis dilation; in 3 it was urinary tract infection; and in 3 it was a n ew ultrasonic sign observed early in the series-ballooning of the rena l pelvis during voiding. Whereas persistent dilation of the renal pelv is was a non-specific indicator (absent in 2 of the 5 affected kidneys and present in 5 of those unaffected), ballooning was consistently se en in all 5 affected renal pelvises. This sign, easily obtained in a b aby who has been sleeping, deserves prospective assessment for its val ue in screening.