Antenatal Hydronephrosis as a Predictor of Postnatal Outcome: A Meta-analysis

Lee, Richard S.; Cendron, Marc; Kinnamon, Daniel D.; Nguyen, Hiep T.

doi:10.1542/peds.2006-0120

Cited by 424 publications

(342 citation statements)

References 53 publications

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“…Very few studies have been published on the prevalence of CH for comparison with our study. Studies on prenatally detected CH show a rate as high as 1%, but these studies also included less severe cases that resolved spontaneously after birth [5,6]. We are aware of three studies published from 1989 to 1993.…”

Section: Discussionmentioning

confidence: 99%

Congenital hydronephrosis: Prenatal diagnosis and epidemiology in Europe

Garne

Loane

Wellesley

et al. 2009

Journal of Pediatric Urology

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Objective: To describe prevalence, prenatal diagnosis and epidemiology of congenital hydronephrosis (CH) in Europe. Material and method: Data from a large European database for surveillance of congenital malformations (EUROCAT). The 20 participating registries are all based on multiple sources of information and include information about livebirths, fetal deaths with gestational age 20 weeks and terminations of pregnancy after prenatal diagnosis of malformations. Included were all cases with CH and born 1995e2004. Results: There were 3648 cases with CH giving an overall prevalence of 11.5 cases per 10,000 births. The large majority of cases were livebirths (3506, 96% of total) and only 17 cases were fetal deaths and 120 were terminations of pregnancy. Almost all livebirths were alive 1 week after birth. Boys accounted for 72% of all cases. A high proportion of the cases (86%) had an isolated renal malformation. There were large regional differences in prevalence of CH ranging from 2 to 29 per 10,000 births. There was little regional variation in the prevalence of postnatally diagnosed cases while there were large regional differences in prevalence of prenatally diagnosed cases. Conclusion: Cases with CH are mainly livebirths, boys and survive the first week after birth. The large difference in prevalence seems to be related to the availability of prenatal screening in the region. The impact of over-diagnosis and potential over-treatment in regions with high prevalence or under-diagnosis with implications for renal function later in life in regions with low prevalence needs further investigation.

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Section: Discussionmentioning

confidence: 99%

Congenital hydronephrosis: Prenatal diagnosis and epidemiology in Europe

Garne

Loane

Wellesley

et al. 2009

Journal of Pediatric Urology

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“…Fetal hydronephrosis (FH) is a common anomaly, affecting 1-5% of pregnancies 8 . With the increasing use of ultrasound in the prenatal evaluation from the mid 80's, hydronephrosis began to be diagnosed in intrauterine life [9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

“…In most cases neonatal hydronephrosis is a benign condition that may even present spontaneous resolution, but it is known that children with antenatal hydronephrosis are at greater risk of postnatal pathology 14 . Therefore, a follow-up protocol that can differentiate patients that will require a surgical approach is an useful tool 15 .…”

Section: Discussionmentioning

confidence: 99%

Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

et al. 2013

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PURPOSE:Fetal hydronephrosis is a frequent finding due to advances in prenatal ultrasonography. The definition of fetal and neonatal urinary tract obstruction is a very difficult task requiring confirmation of reduced renal function and hydronephrosis. In this study we followed a series of consecutive patients with intrauterine hydronephrosis that persisted during post-natal life. METHODS:116 newborns with antenatal hydronephrosis diagnosed by ultrasound and submitted to a specific post-natal evaluative protocol with a follow-up period of 6 years. RESULTS:In 45 (38.8%) of 116 patients, ureteropelvic junction (UPJ) obstruction was confirmed and surgical correction of the UPJ obstruction was done in 19 patients. From 26 children who were initially submitted to non-surgical treatment, only 6 (23%) needed a surgical approach during follow up. Overall analysis showed that surgery was performed in 25 patients with UPJ obstruction, and the others 20 patients were kept under clinical observation, since normal renal function was confirmed by scintigraphy scans. CONCLUSION:Fetal hydronephrosis due to UPJ obstruction deserves careful postnatal evaluation. UPJ obstruction is the most frequent anomaly and its surgical treatment has very precise indications. The evaluative protocol was useful in identify patients that could be followed-up with a non-surgical approach.Key words: Hydronephrosis. Prenatal Diagnosis. Radionuclide Imaging. RESUMO OBJETIVO:Com a ampla utilização dos exames ultrassonográficos na avaliação pré-natal, é frequente o diagnóstico da hidronefrose fetal. A definição de obstrução do trato urinário no periodo pós-natal necessita da confirmação de redução da função renal além da hidronefrose. Neste estudo, acompanhamos uma série de pacientes consecutivos com hidronefrose intra-útero que persistiu no periodo pós-natal. MÉTODOS:116 recém-nascidos com hidronefrose pré-natal diagnosticada pela ultrassonografia foram submetidos a protocolo específico de avaliação e companhados pelo periodo de 06 anos. inicialmente para observação clínica, apenas 6 (23%) necessitaram cirurgia durante o seguimento ambulatorial. Na análise geral, o procedimento cirúrgico para correção da estenose da JUP foi indicado em 25 pacientes. Nas outras 20 crianças não houve necessidade da realização da cirurgia. RESULTADOS:CONCLUSÃO: a hidronefrose fetal requer cuidadosa avaliação pós-natal. A estenose da junção pielo-ureteral é a anomalia mais frequente como causa da hidronefrose, e sua correção cirúrgica tem indicações precisas. O protocolo aplicado foi útil em diferenciar pacientes que não necessitaram cirurgia para tratamento da estenose da JUP. Descritores:Hidronefrose. Diagnóstico Pré-natal. Cintilografia.

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“…Antenatal hidronefrozun derecesi arttıkça vezikoü-reteral reflü ve üreterovezikal bileşke obstrüksiyonu haricinde tüm patolojilerin gelişme riski de artmış olarak saptanmıştır (Tablo 3) (9) . Üçüncü trimesterda AP çap 15 mm'nin üzerinde olan fetüsler prenatal ve postnatal olarak ciddi bir şekilde takip edilmelidir.…”

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