Fetal Hydronephrosis as a Predictor of Neonatal Urologic Outcomes

Shamshirsaz, Alireza A.; Ravangard, Samadh F.; Egan, James; Prabulos, Anne-Marie; Shamshirsaz, Amirhoushang A.; Ferrer, Fernando; Makari, John H.; Leftwich, Heidi; Herbst, Katherine W.; Billstrom, Rachel; Sadowski, Allison; Gurram, Padmalatha; Campbell, Winston A.

doi:10.7863/jum.2012.31.6.947

Cited by 22 publications

(17 citation statements)

References 18 publications

(18 reference statements)

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“…For example, the initial pelvic diameter was significantly higher in Group 2 (for the right kidney). This result suggests that the higher the RP diameter at the time of diagnosis, the greater the possibility that the renal pelvis will remain dilated during pregnancy, which is consistent with the literature 21,34,38.…”

Section: Discussionsupporting

confidence: 89%

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Prenatal natural history of isolated fetal mild bilateral pyelectasis

Pereira¹,

Bunduki²,

Hase³

et al. 2016

Clinics

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OBJECTIVE:To analyze the prenatal outcomes in a cohort of fetuses with mild bilateral pyelectasis and determine whether performing serial ultrasounds is a good follow-up strategy.METHODS:A prospective longitudinal study was conducted on 62 fetuses with mild bilateral pyelectasis. Fetal mild bilateral pyelectasis was considered when the renal pelvis measured (in millimeters) ≥5.0 to 10.0, ≥7.0 to 10.0, and ≥10.0 to 15 at ≤23 weeks 6 days, 24 to 31 weeks 6 days, and ≥32 weeks, respectively, with no uretero-calyceal dilatation. Ultrasounds were performed every 3 weeks to assess whether the mild bilateral pyelectasis regressed, remained unchanged (Group 1) or progressed (Group 2).RESULTS:Group 1 consisted of 53 fetuses (85.4%), and progression was observed in 9 cases (Group 2, 14.6%). The initial renal pelvis diameter was significantly larger in fetuses with progression (p=0.028). Statistically significant differences in the renal pelvis diameter were also found at weeks 31 and 35 for both kidneys (p<0.05). The cases requiring intrauterine procedures or early delivery were not observed.CONCLUSION:Fetal mild bilateral pyelectasis with no calyceal dilatation is a benign condition that can be managed in the postnatal period. The initial renal pelvis diameter and the diameter in week 31 or 35 were valuable parameters for identifying cases that would eventually need specific postnatal procedures.

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Section: Discussionsupporting

confidence: 89%

“…This observation is similar to results in the literature. The relationship of the RP diameter with postnatal prognosis has also been confirmed 5,13,21,27,33-35.…”

Section: Discussionmentioning

confidence: 73%

Prenatal natural history of isolated fetal mild bilateral pyelectasis

Pereira¹,

Bunduki²,

Hase³

et al. 2016

Clinics

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“…This condition-which normally requires no further invasive investigation or treatment-is associated with a milder degree of ANH from AUS findings as in previous studies [4][5][6][7][8][9][10][11]. Additionally, the milder the first PUS is, the more likely the association with transient hydronephrosis.…”

Section: Antenatal Hydronephrosis In Northeastern Thailandsupporting

confidence: 59%

“…Fortunately, none of the patients had progressed to CKD/ESRD, as in similar previous studies [4][5][6][7][8][9][10][11]. However, one of our patients died because of pulmonary hypoplasia and its potential association with hydronephrosis was unclear.…”

Section: Antenatal Hydronephrosis In Northeastern Thailandsupporting

confidence: 55%

“…The incidence of ANH is 1%−5% of all pregnancies [1][2][3][4]. Most cases of ANH are transient hydronephrosis (64%) [4], which usually resolves after postnatal follow-up ultrasound [4][5][6][7][8]. However, some cases are pathological-mostly as a result of ureteropelvic junction (UPJ) obstruction (54.3%), vesicoureteric reflux (VUR) (8.5%), and posterior urethral valve (PUV) (5.3%) [4]-and can deteriorate and may require surgical treatment.…”

mentioning

confidence: 99%

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Outcome of antenatal hydronephrosis in northeastern Thailand

et al. 2014

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Background: Antenatal hydronephrosis (ANH) is a condition characterized by fetal renal pelvic dilatation during pregnancy. It is detected in 1%−5% of all pregnancies. Most cases of ANH are physiological in nature, but some are pathological and can cause morbidity. Objective: To determine: (a) the causes of ANH; (b) the factors associated with complications; and, (c) the factors associated with surgical intervention. Methods: We reviewed the medical records of infants diagnosed with ANH; defined by a renal pelvic anteroposterior diameter ≥5 mm (based on antenatal ultrasonography) and being followed-up at Srinagarind Hospital. Results: Forty-six infants (32 boys and 14 girls) with ANH were identified. Over half (57%) were born in our hospital (in-hospital) with the condition. The two most common causes of ANH were ureteropelvic junction obstruction (32%) and transient hydronephrosis (22%). Of the 63 abnormal kidneys, 52% needed surgical intervention. Twenty-two patients (48%) had urinary tract infections and most had more than 1 episode. None of the 46 patients had end-stage renal disease, but one died because of lung hypoplasia during the neonatal period. The severity of ANH and time of first postnatal ultrasonography were related to medical complications, while bilateral ANH and more severe ANH were associated with the need for surgical intervention. A milder degree of ANH and postnatal ultrasound findings were significantly associated with transient hydronephrosis. Conclusion: Most cases of ANH were pathological and half required surgical intervention. Severe ANH and delayed investigation were associated with poor outcomes.

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