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Category: Volume 11 Issue 04 April 2023
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Title: Postnatal evaluation and outcome of infants with antenatally detected hydronephrosis

Authors: Fatmaelzahraa Ahmed Samy Omer Ahmed, Reham Mohamed Abdelrahman Aboushady, Salwa abdlhak Mostafa

 DOI: https://dx.doi.org/10.18535/jmscr/v11i4.08

Abstract

Introduction: Fetal hydronephrosis is a common abnormality encountered on antenatal ultrasound. Though in majority of cases diagnosed with fetal hydronephrosis there is no underlying cause of such hydronephrosis and it is an isolated abnormality seen on routine ultrasound scan. In majority of these cases hydronephrosis resolves on its own without any intervention. However, in some instances there can be a significant underlying pathology leading to hydronephrosis and in these cases surgical intervention may be required to minimize renal damage. Therefore a strict follow up protocol is essential in infancy for all cases with antenatally detected hydronephrosis.

Aims and Objectives

  1. To find out pathologies causing fetal hydronephrosis.
  2. To analyse the outcome of infants who had been diagnosed with hydronephrosis on antenatal scans.

Materials and Methods: A prospective cohort study conducted in the department of obstetrics and gynaecology in collaboration with department of paediatrics, NMC Royal Hospital Abu Dhabi. 80 infants with antenatally detected hydronephrosis were included in this study on the basis of a predefined inclusion and exclusion criteria. Duration of study was 2 years. All infants with antenatally detected hydronephrosis. Infants were followed up by abdominal ultrasound every month till resolution of hydronephrosis. In selected cases Micturating cystourethrography was done. Pathologies associated with hydronephrosis and outcome was analysed. For statistical purposes p value less than 0.05 was taken as statistically significant.

Results: Infants of 80 women who had been diagnosed with fetal hydronephrosis in second and third trimester were included in this study. The mean gestational age at the diagnosis was found to be 26.34 +/- 8.24 weeks.55 (68.75%) infants had transitional hydronephrosis. Out of remaining 25 (31.25 %) infants 12 (15.00%) infants were found to have PUJ obstruction whereas VUR was seen in 8 (10.00%) patients. In 3 (3.75 %) patients’ posterior urethral was found to be the cause of hydronephrosis. In 25 (31.25%) hydronephrosis completely resolved by 1st follow up scan whereas in 55 (68.75%) infants hydronephrosis completely resolved by last follow up visit. 8 (10%) infants were medically treated by close follow up and prophylactic antibiotics whereas 17(21.25%) infants underwent surgical management in view of significant and progressive hydronephrosis.

Keywords: Fetal Hydronephrosis, Vesicouereteric reflux, posterior urethral valve, outcome.

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Corresponding Author

Fatmaelzahraa Ahmed Samy Omer Ahmed

OBG specialist, Department of Obstetrics and Gynaecology Royal Women’s Hospital, Abu Dhabi, UAE