1. IDENTIFICATION OF VESICOURETERIC REFLEX (VUR) IN THE NEWBORN
JAN SPENCER
MIDWIFE – JAMES COOK UNIVERSITY HOSPITAL

2. IDENTIFICATION OF VUR IN THE NEWBORN
Background
Midwives’ Role – Examination of the Newborn

3. IDENTIFICATION OF VUR IN THE NEWBORN
Case Study – Part 1

4. IDENTIFICATION OF VUR IN THE NEWBORN
Case Study – Part 1
History Taking

5. IDENTIFICATION OF VUR IN THE NEWBORN
Case Study – Part 1
History Taking
VUR – A Challenging Study

6. IDENTIFICATION OF VUR IN THE NEWBORN
Case Study – Part 1
History Taking
VUR – A Challenging Study
Causes

7. IDENTIFICATION OF VUR IN THE NEWBORN

8. IDENTIFICATION OF VUR IN THE NEWBORN
Who gets VUR? It’s all in the Genes

9. IDENTIFICATION OF VUR IN THE NEWBORN
Who gets VUR? It’s all in the Genes
Primary or Secondary?

10. IDENTIFICATION OF VUR IN THE NEWBORN
Grades
I II III IV V
Grade I Into nondilated ureter
Grade II Into pelvis and calyces without dilation
Grade III Mild to moderate dilation of ureter and renal pelvis
Grade IV Moderate dilation and/or tortuosity of ureter
Grade V Severe dilation and tortuosity of ureter, renal pelvis, and calyces

11. IDENTIFICATION OF VUR IN THE NEWBORN
Symptoms

12. IDENTIFICATION OF VUR IN THE NEWBORN
Symptoms
Diagnosis

13. IDENTIFICATION OF VUR IN THE NEWBORN
Symptoms
Diagnosis
Ante Natal Ultrasound

14. IDENTIFICATION OF VUR IN THE NEWBORN
Symptoms
Diagnosis
Ante Natal Ultrasound
Complications

15. IDENTIFICATION OF VUR IN THE NEWBORN
Treatment
Antibiotics Yes
Micturating Cystogram Yes
Antibiotics No
Micturating Cystogram No

16. IDENTIFICATION OF VUR IN THE NEWBORN
South Cleveland Policy

17. IDENTIFICATION OF VUR IN THE NEWBORN
North Trent Protocol 2007

18. IDENTIFICATION OF VUR IN THE NEWBORN
North Trent Protocol 2007
Rivur Trial 2014

19. IDENTIFICATION OF VUR IN THE NEWBORN
Case Study Part 2
HISTORY
ANTENATAL SCAN
EXAMINATION OF NEWBORN
GENETIC IMPLICATIONS FOR FUTURE PREGNANCY
TREATMENT PLAN

20. IDENTIFICATION OF VUR IN THE NEWBORN
Key Points to Note
Importance of ante-natal diagnosis
Antibiotics or not?
Impact of renal scarring
Genetics

21. IDENTIFICATION OF VUR IN THE NEWBORN
Thank you!