Pediatric Urology, Marburg 1, North Wolfe St., Baltimore, MD This review will encompass the identification of antenatal hydronephrosis as. Department of Pediatric Nephrology. Ankara- Antenatal hydronephrosis is present if. APD ≥4 mm in . Sinha A. Indian Pediatrics Neonates with normal. Hydronephrosis. Antenatal hydronephrosis (ANH) is one of the most common abnormal findings Department of Pediatrics, CHA. Bundang.

Author: Magis Zulkizuru
Country: Vietnam
Language: English (Spanish)
Genre: Medical
Published (Last): 27 November 2006
Pages: 32
PDF File Size: 9.9 Mb
ePub File Size: 8.43 Mb
ISBN: 770-1-29686-747-4
Downloads: 72600
Price: Free* [*Free Regsitration Required]
Uploader: Mezitaxe

Since then routine use of ultrasonography for detection of congenital anomalies has become a part of routine care during the antenatal period.

Revised guidelines on management of antenatal hydronephrosis.

A detailed review of the current literature on this topic is provided. Can severely impaired cortical transit predict which children with pelvi-ureteric junction stenosis detected antenatally might benefit from pyeloplasty?

Cortical Transit time has shown promise to antenatl those renal units which are at risk of deterioration of renal function due to obstruction. Do they need prophylactic antibiotics. Clinical characteristics and outcome of hydronephrosis detected by prenatal ultrasonography. Citation of this article. Is antibiotic prophylaxis necessary in infants with obstructive hydronephrosis? The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis. This is a five point severity stratification system which also helps in predicting the need for surgical intervention[ 59 ].

Postnatal management of prenatally detected hydronephrosis is a topic antenstal has evoked widespread interest. Pediatr Med Chir ; It is therefore not acceptable to conclude that the kidney is obstructed simply because of poor drainage. In order to overcome these variations and negate the effect of hydration and full bladder, group from Hong Kong has proposed a Hydronephrosis Index and have given nomograms to help clinicians judge the degree of renal pelvic dilatation based on the gestational age[ 19 ].


Whenever there is hydronephrosis the treating clinician is worried about two things-obstruction and infection. Principles and Practice of Pediatrics 2nd ed.

Also once the bladder is empty, the effect of a distended bladder on the filling and emptying of the collecting system resulting in fallacious diagnosis of pyelectasis is avoided.

Search in Google Scholar for Hydronephgosis R. However undeniably patients with mild hydronephrosis are at much less risk of infection as compared to those with moderate to severe hydronephrosis[ 1232 – 36 ].

However, this is often too late to prevent renal dysplasia. Indian J Pediagrics ; A conventional VCUG would not only diagnose lower grade of VUR but would also exclude the possibility of posterior urethral valve, which can present indolently[ 64 ].

Revised guidelines on management of antenatal hydronephrosis.

Thus, despite all technical precautions, one can end up the test with no or limited renal pelvis emptying, simply due to this reservoir effect[ 66 – 68 ]. In those with VUR chemoprophylaxis should be continued[ 1265 ]. The landmark study by Dhillon et al[ 58 ] inproposed the measurement of APD of the renal pelvis as a means of judging the severity of hydronephrosis and predicting the need for surgery.

All infants detected to have ANH should be evaluated by a postnatal ultrasound, which is usually done at d after birth[ 1137 ] for the reasons described above.

Search Pubmed for Mathews R. Analysis of trends on serial ultrasound for high grade neonatal hydronephrosis. Current management of antenatal hydronephrosis.


Antenatal hydronephrosis current evaluation and management Mathews R – Indian J Urol

Therefore, features such as calyceal dilatation and parenchymal thinning should also be considered in grading the severity of hydronephrosis. They can be taken easily and even an infant can be held in the arms of the parent to obtain the post erect images. These patients are on prophylactic antibiotics, hence to diagnose or rule out VUR, it would be prudent to wait till the neonate is old enough. Postnatal management of infants with antenatally detected hydronephrosis.

Diuresis renography in equivocal urinary tract obstruction. Long-term outcomes in children treated by prenatal vesicoamniotic shunting for lower urinary tract obstruction. An interesting feature of this study has been the effort to separate pyelectasis from hydronephrosis so that postnatal ultrasound can be avoided in a number of patients.

The management of this condition hydronephrodis raised considerable debate amongst clinicians dealing with it. Correlation of hydronephrosis index to society of fetal urology hydronephrosis scale. Also does it alter the prognosis significantly and does the benefit outweigh the pediartics should be evaluated diligently. Day two of life is preferred to enable adequate hydration after delivery but circumstances pertaining to early discharge following delivery may not allow this.

Hence a thorough postnatal evaluation of the upper and lower tracts is mandatory postnatally.