Indian Journal of Obstetrics and Gynecology Research


Analysis of postnatal outcomes of prenatally detected fetal hydronephrosis


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Author Details: Chitra Andrew, M.A. Fathimunissa, Shivani Gopal

Volume : 3

Issue : 2

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 104

Article End Page : 109


Abstract

Background: Prenatal hydronephrosis comprises 20% of the anomalies detected on ultrasound. Adequate information is required to counsel the parents regarding the diagnosis and possible need for further evaluation and postnatal therapy including surgery. The aim of the study is to analyse the postnatal outcomes of neonates with prenatal diagnosis of hydronephrosis.
Material and Methods: Fetuses diagnosed with hydronephrosis from January 1, 2014 to May 31, 2015 were identified from the obstetric ultrasound database. 27 fetuses had a diagnosis of hydronephrosis and had complete postnatal follow-up. These were classified on the basis of the severity and bilaterality of hydronephrosis. Postnatal data and follow up was obtained from the hospital records and from the parents over phone when delivery had occurred at another institution. 
Results: Of 27 fetuses, 15 were diagnosed in second trimester and 13 in the third trimester due to late booking. No fetuses with a normal scan at second trimester subsequently developed hydronephrosis. Of 18 fetuses with mild hydronephrosis, 17 were seen to be normal at prenatal follow up or postnatally. Only one progressed and became severe requiring postnatal surgery. Of the nine fetuses classified as moderate or severe, seven neonates required surgery in the neonatal period. On comparing the two groups, this was found to be statistically significant. (p:0.005). The effect of bilateral hydronephrosis on outcomes could not be assessed due to the small numbers of fetuses in this category.
Conclusion: Antenatal diagnosis of fetal hydronephrosis may progress and so parents need to be counselled regarding the need for a follow up scan which will then determine the need for post-natal follow up or treatment. Severity of the hydronephrosis seen antenatally influences the need for surgery in the neonate.