Assessing Outcome of Antenatal Hydronephrosis- An Integrated Clinical Approach

Chaudhary, Sanjay; Shah, Amit Kumar

doi:10.18410/jebmh/2018/221

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…The current study findings are consistent with that of a previously published study showing that ANH resolved in 41.2% of patients and reached a good prognosis within two months with a value of 48.4% of participants exhibited good prognosis [12]. Altogether, our study and the studies by Kari et al and Chaudhary and Shah suggest that the outcome is possibly affected by the severity of ANH [12,26].…”

Section: Discussionsupporting

confidence: 93%

“…The finding that there was a relationship between patients who exhibited a UTI, with one or more associated conditions, such as VUR, and UPJO, and ANH prognosis could indicate that the presence of multiple ANH-associated comorbidities may increase the burden on health and thereby decrease overall ANH outcomes. Nevertheless, it is important to note that a previous study reported a poor correlation between VUR grade and ANH severity, suggesting that there might be nuances to this connection, which have yet to be discovered [26]. It is possible that including VUR grading into the current study would have yielded more definitive results and addressed this potential discrepancy.…”

Section: Discussionmentioning

confidence: 83%

“…Concerning gender characteristics among the current study participants, the male-to-female ratio of 2.4:1 was expected. Also, previous research showed that ANH is more common in males [8,12,14,[25][26].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the Etiologies and Outcomes of Antenatal Hydronephrosis in Patients at King Abdulaziz University Hospital

Safdar

Safhi

Saggaf

et al. 2020

Cureus

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Background Antenatal hydronephrosis (ANH) is the most common congenital abnormality. It is often detected during pregnancy through an antenatal ultrasound (US) examination. This condition is defined as the dilatation of the renal pelvis and/or calyces in neonates. Little is known about ANH and its associated etiology and outcomes, especially in the Middle East. This study aims to determine the outcome of patients diagnosed with ANH between 2011 and 2017. Methods The current study was a retrospective analysis of data collected from the medical records of 64 ANH patients (45 male, 19 female). We collected data regarding the demographic characteristics, fetal parameters, laboratory and radiological parameters, and medical and surgical interventions. Moreover, based on radiological reports patients were classified into one of the following two groups: good prognosis, including patients with improved or resolved ANH and poor prognosis, including patients with progressing ANH and associated complications such as parenchymal scarring, chronic kidney disease complicated by secondary hypertension. Results Overall, 48.4% of patients exhibited good prognosis, whereas 51.6% exhibited poor prognosis. Among the 64 patients, 53.1% of patients exhibited unilateral ANH, and 46.9% exhibited bilateral ANH. Also, unilateral ANH and bilateral ANH had good prognoses in 41.2% and 56.7%, respectively, while unilateral and bilateral ANH had poor prognosis in 58.8% and 43.3%, respectively. Conclusions Additional prophylactic measures should be taken to avoid complications, such as urinary tract infection (UTI), as our study found that patients who have ANH are more prone to develop UTI. Patients with several ANH comorbidities are associated with poor prognosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 83%

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Assessment of the Etiologies and Outcomes of Antenatal Hydronephrosis in Patients at King Abdulaziz University Hospital

Safdar

Safhi

Saggaf

et al. 2020

Cureus

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“…Fifty to ninety percent of cases of mild hydronephrosis tend to resolve within the first two months of age. 6,8, 10 Others are caused by severe structural issues such as pelvic-ureteric junction (PUJ) obstruction, posterior urethral valve (PUV) or vesicoureteral reflux (VUR). 6 Although Mild renal pelvis dilatation is typically incidental and benign, it is a frequent and generic observation that can also be linked to structural and genetic problems.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Outcome of Babies with Antenatal Renal Pelvis Dilatation (RPD)

Siddique¹,

Gul²,

Anwar³

et al. 2022

PJMHS

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Background: Antenatal renal pelvis dilatation (RPD) is the most common congenital renal anomaly detected on antenatal ul-trasound. The present study was planned to determine the characteristics and outcome of neonates with antenatal renal pel-vis dilatation. Patients and Methods: A prospective, observational, non-interventional study was conducted in Fatima Memorial Hospital over a period of 12 months from April 2021 to March 2022. This study included 130 kidneys of 91 neonates >28 weeks of gestation with antenatally diagnosed isolated renal pelvis dilatation. Postnatal ultrasound was performed at 24-72 hours of life. Cases those resolved spontaneously were labelled as Physiological RPD (Transient RPD) , while all others were labelled as Pathological RPD (Persistent RPD).Descriptive statistics and tests of significance were calculated for all variables. Univariate analysis was performed to compare all possible risk factors for postnatal transient vs. persistent RPD of any grade. Correla-tion coefficients were calculated between risk factors with pathological RPD. Results: Every 4th neonate of antenatally diagnosed RPD had persistent RPD (p<0.05). Only 5% of neonates showed a se-vere variety of persistent RPD. Statistically significant risk factors associated with pathological RPD were maternal anemia, oligohydramnios, diabetes mellitus, gestation age < 37 weeks, birth weight <3 kg, antibiotics administration, admission in in-tensive care unit, urinary tract infections, oliguria, high BUN and creatinine, posterior urethral valve, vesicoureteral reflux, neurogenic bladder and other urinary tract malformations (P<0.05). Persistent RPD had a strong positive direct correlation with the severity of antenatally diagnosed RPD, a moderate positive correlation of persistent RPD was seen with maternal anemia, oligohydramnios, high serum creatinine, PUV, and PUJ. Hence the study will help us in formulating management and follow up plan of our newborns with antenatal RPD. Conclusion: About 71% of neonates with antenatally diagnosed RPD undergo spontaneous resolution. Severe antenatally diagnosed RPD persisted in neonatal life and persistent RPD has a strong correlation with the severity of renal pelvis dilata-tion. Keywords: Ultrasonography, Renal Pelvis Dilatation (RPD), Antenatal, Postnatal, PUJ, Urinary tract malformation, neonatal kidney.

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Occurrence of Vesicoureteral Reflux among the Antenatally Detected Urinary Tract Dilation/Antenatal Hydronephrosis

Ahmed,

Ashraf,

Mir

et al. 2022

Journal of Clinical Neonatology

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Background: Approximately 1% of pregnancies on obstetric ultrasound (US) are associated with structural fetal anomalies, among whom 20% are of the genitourinary system. Objective: The objective of this study was to determine the occurrence of vesicoureteral reflux (VUR) among the antenatally detected urinary tract dilation (UTD)/antenatal hydronephrosis (ANH) on postnatal follow-up. Methods: The study was a prospective observational study where the presence of anterior-posterior renal pelvis diameter (APRPD) of the fetal kidneys on obstetric ultrasound of >4 mm in the second trimester or >7 mm in the third trimester was taken to diagnose UTD/ANH were enrolled for the follow-up of successive US scans postnatally on the 7th, 30th, and 45th day of life. Patients with APRPD >4 mm postnatally, were subjected to micturating cystourethrogram (MCUG) at or after 45 days of life. Results: A total of 61,587 pregnant women visited the outpatient department, among whom 10,800 pregnant women underwent US scanning for fetal well-being during the second trimester, where 119/10,800 (1.1%) had UTD/ANH. A total of 21 patients were excluded from the study for various reasons and 98 patients were on follow-up. Postnatally on the 7th day of life, UTD/hydronephrosis (HDN) was detected in 41/98 (41.8%), as 57/98 (58.2%) neonates had no UTD/HDN. VUR was detected in 21/98 (21.4%) on MCUG. Conclusion: Around three-fifth of fetal UTD/ANH had a spontaneous resolution, whereas 2/5th has persistent UTD/HDN. Moderate and severe UTD/ANH infants possess a high risk of VUR as was observed in the present study and mandates a careful follow-up, to avoid any medical/surgical eventuality.

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Assessing Outcome of Antenatal Hydronephrosis- An Integrated Clinical Approach

Cited by 3 publications

References 11 publications

Assessment of the Etiologies and Outcomes of Antenatal Hydronephrosis in Patients at King Abdulaziz University Hospital

Assessment of the Etiologies and Outcomes of Antenatal Hydronephrosis in Patients at King Abdulaziz University Hospital

Characteristics and Outcome of Babies with Antenatal Renal Pelvis Dilatation (RPD)

Occurrence of Vesicoureteral Reflux among the Antenatally Detected Urinary Tract Dilation/Antenatal Hydronephrosis

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