ANTENATAL DIAGNOSIS OF HYDRONEPHROSIS AND ITS POSTNATAL OUTCOME

Abstract

INTRODUCTION-Fetal hydronephrosis
is the most common anomaly detected
on antenatal ultrasound examination, affecting
1-5 percent of pregnancies. Despite
its frequency, the appropriate postnatal
management of prenatal hydronephrosis
(PNH) is not well defined.
Prenatal ultrasound identifies the whole
spectrum including many children from
the milder end, there by exposing them
to excessive imaging both pre and postnatally.
Prenatal hydronephrosis is diagnosed
at an incidence of 1100 to 1500 by
ultrasonographic studies. AIM-The aim of
the study is to assess the outcome of fetal
hydronephrosis postnatally. MATERIALS
AND METHODS- Postnatal evaluation
was uniformly done and the decision
for intervention was made by a single pediatric
surgeon. Based on the 32-week
fetal ultrasound findings, patients were
divided into two groups Group I
(unilateral hydronephrosis) and group II
(bilateral hydronephrosis). Statistical
analysis was done using
Fisher's exact test and Chi-square test and
outcome was considered significant when
the P value was less than 0.05. RESULTSAmong
a total of 58 patients registered, 8
patients were excluded due to lack of follow
up, leaving 50 in our study group. Out
of 50 patients 34 patients were under
Group I and 16 were under Group II. In
Group I out of 34 patients 5 patients has
undergone surgery (14.7) and in Group II
out of 16 patients 11 patients has undergone
surgery (68.7). Chi-square test is p is
0.02. DISCUSSION- Antenatal diagnosis of
hydronephrosis causes significant distress
to the parents during pregnancy. Lee et al
1 in their meta analysis on the outcome of
antenatal hydronephrosis, have quoted that
children with any degree of antenatal hydronephrosis
are at a greater risk of postnatal
pathology compared to normal population.
Grignon et al 10 quoted that if the
APD was more than 30 then 95 of the patients
had a significant abnormality requiring
surgery and long term follow up which
is similar to our study.CONCLUSIONPostnatal
outcome of

a fetal hydronephrosis is mainly dependent on
the early detection continuous monitoring of
the renal status and the APD diameter, timely
intervention based on the disease improve the
morbidity and prevent mortality.