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Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography  

Park, Youn Jin (Department of Pediatrics, College of Medicine, Kyung Hee University)
Mun, Soon Jung (Department of Pediatrics, College of Medicine, Kyung Hee University)
Bae, Chong Woo (Department of Pediatrics, College of Medicine, Kyung Hee University)
Lee, Bum Ha (Department of Radiology, College of Medicine, Kyung Hee University)
Kim, Jin Il (Department of Urology, College of Medicine, Kyung Hee University)
Publication Information
Clinical and Experimental Pediatrics / v.45, no.10, 2002 , pp. 1213-1218 More about this Journal
Abstract
Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.
Keywords
Fetal hydronephrosis; Out-come; Prenatal ultrasonography;
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