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Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography

Journal of the Korean Pediatric Society 2002;45(10):1213-1218.
Published online October 15, 2002.
Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography
Youn Jin Park1, Soon Jung Mun1, Chong Woo Bae1, Bum Ha Lee2, Jin Il Kim3
1Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea
3Department of Urology, College of Medicine, Kyung Hee University, Seoul, Korea
산전 초음파로 진단된 태아 수신증의 생후 경과 관찰
박연진1, 문수정1, 배종우1, 이범하2, 김진일3
1경희대학교 의과대학 소아과학교실
2경희대학교 의과대학 진단방사선과학교실
3경희대학교 의과대학 비뇨기과학교실
Correspondence: 
Chong Woo Bae, Email: baecwkmc@zaigen.co.kr
Abstract
Purpose
: Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram.
Methods
: The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG).
Results
: The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case.
Conclusion
: Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.
Key Words: Fetal hydronephrosis, Out-come, Prenatal ultrasonography


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