Management of neonatal hydronephrosis

Belarmino, James; Kogan, Barry A.

doi:10.1016/j.earlhumdev.2005.11.004

Cited by 52 publications

(60 citation statements)

References 16 publications

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“…Many investigators, however, have not mentioned any loss of patients in their ANH programs. [4][5]7,10,14,[19][20] In one-fourth of cases, our MFM specialists recommended follow-up after birth with their pediatrician. As suggested by our data, half of these infants were deemed to be healthy and no postnatal renal US or other consultations were done.…”

Section: Discussionmentioning

confidence: 99%

“…Although an abdominal mass may be the presenting sign of neonatal hydronephrosis, this is rare and in most cases these infants are asymptomatic. 10,21 It is now widely accepted that only after two normal renal US (one after 5 days and another at 1 month) can resolution of ANH be entertained. 2,7 Another recommendation commonly made by MFM specialists was to seek postnatal follow-up directly with the urologist.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,7 -9 Successful management of ANH requires dependable fetal surveillance, prompt neonatal evaluation, including sonography, and when indicated, referral to a pediatric urology service for further consultation and/or treatment. [3][4]10 Although some investigators have expressed concerns regarding compliance with postnatal consultation, the majority of them did not address the specific question of how many infants never benefited from established ANH follow-up. 1,3-4,11 -13 Methods The Regional Perinatal Center (RPC) is comprised of Maternity and Newborn services at The Ohio State University Medical Center (OSUMC) and Neonatology and Pediatric Urology services at Nationwide Children's Hospital (NCH).…”

Section: Introductionmentioning

confidence: 99%

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Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

et al. 2009

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Objective: To examine our experience with ANH and to determine the success of our postnatal follow-up program.Study Design: Charts of mothers and infants seen (2004 to 2008) at our Regional Perinatal Center were reviewed retrospectively. ANH was defined during the third trimester by anterior pelvic diameters as follows: mild 7 to 9, moderate 10 to 14 or severe X15 mm. Fetuses with multicystic dysplastic kidney (MCDK) were included. Result:Screening of approximately 15 000 ultrasound (US) reports identified 268 fetuses with ANH. After prenatal US surveillance, 88 (33%) fetuses had resolved, while 180 (67%) required postnatal follow-up. These 180 fetuses were diagnosed with mild 38 (21%), moderate 83 (46%) and severe 19 (11%) ANH, uni or bilateral hydroureters 12 (7%), MCDK 19 (10%) and miscellaneous 9 (5%). Postnatal follow-up was successfully established for 75% of infants with hydroureters, 68% for those with MCDK and for 37% of infants with mild, 53% with moderate and 58% with severe ANH. Factors commonly known to influence compliance were not found more frequently among the 91 infants who were lost to follow-up. The only positive predictor for postnatal follow-up was a prenatal consultation with the pediatric urologist. 1-4 The majority of these fetuses recover spontaneously but approximately 40% require postnatal follow-up, and in half of these cases, medical or surgical intervention was needed to prevent significant renal damage. The spectrum of genitourinary abnormalities detected antenatally is varied but the majority of patients have ANH.5 It is commonly accepted that no specific etiology can be identified in 48% of ANH cases.1-5 Physiologic changes are seen in 15%, ureteropelvic and ureterovesical junction obstructions account for 11% of the cases, 9% have vesicoureteral reflux, 4% have unilateral or bilateral megaloureters, 2% of all cases have multicystic dysplastic kidney (MCDK) and 1% have ureterocele. 1,3,6 Regardless of the cause, it is expected that about half of the ANH cases will resolve before delivery or during the first year of life. 2,6 For the other half there will be a need for postnatal follow-up as persistent uropathy is expected to occur in 12% of mild, 45% of moderate and 88% of severe ANH cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

et al. 2009

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“…3 While it is believed that prophylactic antibiotics will prevent urinary tract infections in children with VUR, it has yet to be proven. 4 Therefore, some recommend institution of prophylactic antibiotics at birth; 1,5 others instead recommend a low threshold for investigation and treatment of a suspected UTI. 3 Commonly used prophylaxes in the neonate include amoxicillin 1 50 mg per day and cephalexin 6 50 mg per day.…”

Section: Prophylactic Antibioticsmentioning

confidence: 99%

Investigation and management of antenatally detected hydronephrosis

Psooy

Pike

2013

CUAJ

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“…In the majority of cases (63%) prenatal hydronephrosis can be associated with normal renal physiology. Frequently this finding could spontaneously return to normal during the first year of life requiring only a clinical follow up 3 . 50% of antenatal cases detected after 28 weeks gestation has postnatal imaging that are normal 4 .…”

Section: Introductionmentioning

confidence: 96%

Fetal Hydronephrosis, A Case Report And Review of Literature

Shamsunnahar

Motaleb

Begum

et al. 2015

J. paediatr. surg. Bangladesh

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Abstract:With the increasing use of antenatal sonography, fetal hydronephrosis has been reported more frequently. Hydronephrosis is one of the most commonly identified prenatal anomalies, and the severity may vary from mild to severe, depending on the underlying cause. Many cases resolve spontaneously before birth, but for those that do not, the additional prenatal evaluation can identify cases sufficiently severe to require fetal intervention to preserve renal function. The benefits of these interventions must be balanced against the significant risks of the procedures and their sequelae in long-term efficacy. Evaluation before and after birth is warranted, and factors such as cause, severity, and whether the condition is uni-or bilateral are used to formulate decisions about additional assessment and potential intervention. Here we report a case of bilateral hydronephrosis which was detected during pregnancy. After delivery right side spontaneously resolves but there was worsening of left hydronephrosis in follow up and He undergoes a left pyeloplasty at 6 months of age and does well post operatively.

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Management of neonatal hydronephrosis

Cited by 52 publications

References 16 publications

Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

Postnatal follow-up of antenatal hydronephrosis: a health-care challenge

Investigation and management of antenatally detected hydronephrosis

Fetal Hydronephrosis, A Case Report And Review of Literature

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