Postnatal outcome of isolated antenatal hydronephrosis

OBJECTIVE: To assess the postnatal outcome of fetuses with renal pelvis dilatation (RPD).

METHODS: A retrospective study was conducted to review 61 fetuses found to have RPD by ultrasound (US) carried out from January 2008 to January 2012 at the Security Forces Hospital in Riyadh, Kingdom of Saudi Arabia. Five ended with intra uterine fetal death or early neonatal death, and were excluded. Of the remaining 56 cases, 22 cases were lost to follow up, and we were not able to contact them so were excluded. The remaining 34 cases were followed-up in our hospital, and their outcome were analyzed. The main outcome measures include: incidence of RPD diagnosed in our population, degree of hydronephrosis, postnatal diagnosis, and need for surgical intervention. Data on pregnancy and fetal outcome were collected from the files of the patients.

RESULTS: Out of the 990 cases with sonographic abnormalities detected by antenatal US, the incidence of isolated RPD was 6.1%. Out of 34 cases, 15 patients had severe RPD (44% of cases), 41% of cases (14 patients) had moderate RPD, and 15% of cases (5 patients) had mild RPD, only 7 patients (21%) required surgery after delivery.

CONCLUSION: The routine use of antenatal ultrasonography will lead to early diagnosis of urologic conditions that have postnatal consequences.