Management of the fetus and neonate with hydronephrosis detected by prenatal ultrasonography

Postnatal management of hydronephrosis diagnosed in utero

In this review we identify the causes of antenatal hydronephrosis and detail management options. A large majority of these patients can be treated safely and effectively after birth.

Ultrasonographic screening for renal abnormalities in three-year-old children

We report the results of ultrasonographic screening to determine the prevalence of renal abnormalities in children. This study was conducted simultaneously with a regular health check using portable realtime ultrasound equipment, from July 1988 to June 1989. Of 2920 three-year-old children resident in Kurume City, 2351 (80.5%) were screened. Abnormalities were detected in 11 (0.47%) of these, involving six cases of pelvic dilatation, three cases of unilateral renal agenesis, and two cases of a unilaterally small kidney. However, the simultaneous urinalysis of these 11 children did not disclose these abnormalities. Our results indicate that ultrasonography is an efficient tool for screening for a silent renal abnormality.

Outcome of antenatally diagnosed pelviureteric junction hydronephrosis

Over a 6-year period, in a series of 107 consecutive patients with antenatally detected urological anomalies, 45 had pelviureteric junction (PUJ) hydronephrosis (66 units). Of these, 24 units (36%) had obstructive (group I) and 42 (64%) non-obstructive hydronephrosis (group II). Significantly compromised renal function was found only in group I. Treatment in group I was by an early pyeloplasty; in group II the patients were kept under close review. During the 6-year period, 2 units (5%) in group II, deteriorated, 13 (31%) improved and 27 (64%) were unchanged. These results suggest that early in life, antenatally diagnosed PUJ hydronephrosis without obstruction may be a relatively benign condition but will require long-term follow-up in order to determine the natural history of the condition.