All issues > Volume 45(10); 2002

Original Article

J Korean Pediatr Soc. 2002;45(10):1213-1218. Published online October 15, 2002.

Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography

Youn Jin YJ Park¹, Soon Jung SJ Mun¹, Chong Woo CW Bae¹, Bum Ha BH Lee², Jin Il JI 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

Correspondence Chong Woo CW 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.

Keywords :Fetal hydronephrosis, Out-come, Prenatal ultrasonography