Association between Severity and Etiology of Antenatal Hydronephrosis in Neonates
Journal of Pediatric Nephrology,
Vol. 7 No. 4 (2019),
29 December 2019
Background and Aim: Antenatal hydronephrosis refers to the dilation of renal pelvis during fetal development. This condition is commonly diagnosed during intrauterine ultrasonography. According to available statistics, fetal anomalies are seen in about 0.5-2.5% of intrauterine ultrasound examinations. The most common anomaly is hydronephrosis. The severity of renal pelvic dilatation in the first sonography after birth may help to diagnose the underlying cause of antenatal hydronephrosis. On the other hand, knowledge of the etiology of hydronephrosis can help to understand the clinical course of the disease and to determine an appropriate therapeutic protocol for patients.
Methods: In this descriptive cross-sectional study, all infants with antenatal hydronephrosis referred to the pediatric nephrology clinic of Imam Khomeini Hospital, Ilam, Iran were evaluated. Considering a hydronephrosis frequency of 50%, confidence interval of 95%, and error rate of 13%, the sample size was calculated at 60 subjects.
Results: This study was performed in 61 neonates with antenatal hydronephrosis, including 43 (70.5%) males and 18 (29.5%) females. The frequency of hydronephrosis was significantly higher in boys than girls. Non-obstructive hydronephrosis was the most common underlying etiology in the patients. Most of the infants had a mild hydronephrosis. UPJO (ureteropelvic junction obstruction) was the most common cause of hydronephrosis. Furthermore, most of the patients had bilateral hydronephrosis.
Conclusion: Non-obstructive hydronephrosis accounted for about 50% of antenatal hydronephrosis cases in this study. The intensity of the pelvic dilatation was directly associated with obstructive hydronephrosis, which can be used as a diagnostic guide.
Keywords: Hydronephrosis; Etiology; Neonates; Severity.
How to Cite
Merguerian PA, Herz D, McQuiston L, Van Bibber M. Variation among pediatric urologists and across 2 continents in antibiotic prophylaxis and evaluation for prenatally detected hydronephrosis: a survey of American and European pediatric urologists. J Urol 2010; 184(4 Suppl): 1710-5.
Mohammadjafari H, Alam A, Kosarian M, Mousavi SA, Kosarian Sh. Vesicoureteral reflux in neonates with hydronephrosis; role of imaging tools. Iran J Pediatr 2009; 19(4): 347-53.
Yamacake KG, Nguyen HT. Current management of antenatal hydronephrosis. Pediatr Nephrol 2013; 28(2): 237-43.
St Aubin M, Willihnganz-Lawson K, Varda BK, Fine M, Adejoro O, Prosen T, et al. Society for fetal urology recommendations for postnatal evaluation of prenatal hydronephrosis will fewer voiding cystourethrograms lead to more urinary tract infections? J Urol 2013; 190(4 Suppl): 1456-61.
Romao RL, Farhat WA, Pippi Salle JL, Braga LH, Figueroa V, Bagli DJ, et al. Early postoperative ultrasound after open pyeloplasty in children with prenatal hydronephrosis helps identify low risk of recurrent obstruction. J Urol 2012; 188(6): 2347-53.
Alconcher LF, Tombesi MM. Natural history of bilateral mild isolated antenatal hydronephrosis conservatively managed. Pediatr Nephrol 2012; 27(7): 1119-23.
Yiee JH, Tasian GE, Copp HL. Management trends in prenatally detected hydronephrosis: national survey of pediatrician practice patterns and antibiotic use. Urology 2011; 78(4): 895-901.
Valent-Moric B, Zigman T, Cuk M, Zaja- Franulovic O, Malenica M. Postnatal evaluation and outcome of infants with antenatal hydronephrosis. Acta Clin Croat 2011; 50(4): 451-5.
Sharma G, Sharma A, Maheshwari P. Predictive value of decreased renal pelvis anteroposterior diameter in prone position for prenatally detected hydronephrosis. J Urol 2012; 187(5): 1839-43.
Longpre M, Nguan A, Macneily AE, Afshar K. Prediction of the outcome of antenatally diagnosed hydronephrosis: a multivariable analysis. J Pediatr Urol 2012; 8(2): 135-9.
Ismaili K, Avni FE, Piepsz A, Wissing KM, Cochat P, Aubert D, Hall M. Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists. Pediatr Nephrol 2004; 19:966–71.
Toiviainen-Salo S, Garel L, Grignon A, Dubois J, Rypens F, Boisvert J, et al. Fetal hydronephrosis: is there hope for consensus? Pediatr Radiol 2004;34:519–29.
Coelho GM, Bouzada MCF, Pereira AK, Figueiredo BF, Leite MRS, Oliveira DS, et al. Outcome of isolated antenatal hydronephrosis: a prospective cohort study. Pediatr Nephrol 2007; 22:1727–34.
Bastug F, Gunduz Z, Tulpar S, Poyrazoglu H, Dusunsel R. Urolithiasis in infants: evaluation of risk factors. World J Urol 2013; 31(5): 1117-22.
Naseri M. Urolithiasis in Asian children: Evaluation of metabolic factors. Journal of Pediatric Biochemistry 2013; 3(4): 225-38.
Alemzadeh-Ansari MH, Valavi E, Ahmadzadeh A. Predisposing factors for infantile urinary calculus in south-west of Iran. Iran J Kidney Dis 2014; 8(1): 53-7.
Safaei-Asl A, Maleknejad S. Pediatric Urolithiasis; An Experience of a Single Center. Iran J Kidney Dis 2011; 5(5): 309-13.
Rickwood AM, Reiner I. Urinary stone formation in children with prenatally diagnosed uropathies. Br J Urol 1991; 68(5): 541-2.
Roth JA, Diamond DA. Prenatal hydronephrosis. Curr Opin Pediatr 2001;13:138–41
Shokeir AA, Nijman RJM. Antenatal hydronephrosis: changing concepts in diagnosis and subsequent management. Br J Urol 2000; 85:987-94
Reddy P, Mandell J. Prenatal diagnosis: therapeutic implications. Urol Clin North Am 1998; 25:171–80.
Woodward M, Frank D. Postnatal management of antenatal hydronephrosis. BJU Int 2002; 89: 149-56.
Dae JL, Jae-Young P, Jeong HK, Sung HP, Seung-June O, Hwang C. Clinical characteristics and outcome of hydronephrosis detected by prenatal ultrasonography. J Korean Med Sci 2003; 18:859-62.
Marcio LM, Lourenco S, Antonio AMF, Hugo FK, Ricardo B, Joaquim MBS. Prenatal Hydronephrosis. Pediatr Urol 2002;28:147-53.
Uluocak N, Ander H, Acar O, Amasyali AS, Erkorkmaz U, Ziylan O. Clinical and radiological characteristics of patients operated in the first year of life due to ureteropelvic junction obstruction: significance of renal pelvis diameter. Urology 2009 ;74(4):898-902.
- Abstract Viewed: 404 times
- PDF Downloaded: 123 times