Follow up of antenatal and neonatally detected hydronephrosis

Follow up of Antenatal and Neonatally Detected HydronephrosisObjective: Ureteropelvic junction obstruction is the most common cause of antenatal hydronephrosis and, prevalence is approximately 1 % of pregnancies. There is no precise critera to say, what will be the situation of the hydronephrotic kidney in the future, which kidneys will preserve their function and which will require surgical intervention. In this prospective clinical study, we aimed to determine the prognosis of hydronephrosis in patients that were diagnosed antenatally and postnatally and then followed and treated.Materials and Methods: In this prospective study, we followed 31 patients. All were diagnosed as hydronephrosis by ultrasonography antenatally or in the first seven days postnatally and followed at the Department of Pediatric Surgery, Çukurova University Faculty of Medicine between September 2009-June 2012.Results: We detected ureteropelvic junction obstruction in 22 of 31 (71 %) patients and multicystic dysplastic kidney in four (12.9 %). Between 5th-7th days, anteroposterior diameter greater than 15 mm (p=0,003), grade III and IV hydronephrosis (p=0,001) according to classification of Society of Fetal Urology and grade II, III, IV hydronephrosis (p=0,001) according to Önen?s classification are statistically significant and none of them is superior to each other for surgical decision. During one-year follow-up period, 13 (42 %) patients underwent surgical treatment. There was just one renal cortical defect at scintigraphy. At the end of first year, we didn?t see any statistically significant difference between antero-posterior pelvis diameter (p=0,374) of surgically treated patients and patients without surgical approach.Conclusion: The results of anteroposterior diameter, Society of Fetal Urology?s and Önen?s hydronephrosis classifications in terms of follow-up and necessity of surgical intervention are reliable and close to each other. Close follow-up of these patients by ultrasound and surgical intervention at the right time can protect kidney from parenchymal damage.