Clinical relevance and implications of antenatal hydronephrosis
JA Dudley, JM Haworth, ME McGraw, JD Frank… - Archives of Disease in …, 1997 - fn.bmj.com
JA Dudley, JM Haworth, ME McGraw, JD Frank, EJ Tizard
Archives of Disease in Childhood-Fetal and Neonatal Edition, 1997•fn.bmj.comDetailed antenatal sonography was performed on 18 766 pregnant women between 1990
and 1994. Antenatal hydronephrosis, defined as an antero-posterior diameter of the renal
pelvis (APPD) greater than 5 mm, was detected in 100 cases (0.59%). Sixty four infants had
postnatal hydronephrosis at one and/or six weeks after delivery; 21 of these had urological
anomalies. Twelve infants had vesico-ureteric reflux. In all refluxing units the APPD of the
renal pelvis was less than 10 mm. Three patients had obstruction at the pelvi-ureteric …
and 1994. Antenatal hydronephrosis, defined as an antero-posterior diameter of the renal
pelvis (APPD) greater than 5 mm, was detected in 100 cases (0.59%). Sixty four infants had
postnatal hydronephrosis at one and/or six weeks after delivery; 21 of these had urological
anomalies. Twelve infants had vesico-ureteric reflux. In all refluxing units the APPD of the
renal pelvis was less than 10 mm. Three patients had obstruction at the pelvi-ureteric …
Detailed antenatal sonography was performed on 18 766 pregnant women between 1990 and 1994. Antenatal hydronephrosis, defined as an antero-posterior diameter of the renal pelvis (APPD) greater than 5 mm, was detected in 100 cases (0.59%). Sixty four infants had postnatal hydronephrosis at one and/or six weeks after delivery; 21 of these had urological anomalies.
Twelve infants had vesico-ureteric reflux. In all refluxing units the APPD of the renal pelvis was less than 10 mm. Three patients had obstruction at the pelvi-ureteric junction (PUJ); all required surgery.
Vesico-ureteric reflux is emerging as the most common urological finding in infants with antenatal hydronephrosis and is likely to be missed if kidneys with APPD of less than 10 mm are not further investigated. In contrast, pelvi-ureteric junction obstruction may be overdiagnosed, based only on drainage patterns of dynamic renogram studies.
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