Prospective study on outcome of antenatally detected hydronephrosis from a tertiary care center in south India

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International Journal of Development Research

Volume: 
7
Article ID: 
10386
5 pages
Research Article

Prospective study on outcome of antenatally detected hydronephrosis from a tertiary care center in south India

Gopika Prasad, Susan Uthup, Geetha, S., Santhosh Kumar, A., Ashok Kumar, G.M. and Jayasree, L.

Abstract: 

Background: Hydronephrosis (HDN) is the commonest renal anomaly detected on antenatal ultrasonography. There are at present controversies in its investigation and management. The study aims at assessing the outcome of antenatal hydronephrosis (ANH) in our setting and the factors determining the persistence postnatally, which would definitely be helpful for future prognostication. Material and Methods: A hospital based prospective cohort study was conducted to assess the postnatal persistence of ANH for a period of 2 years after obtaining clearance from human ethics committee. We aimed to find out the postnatal outcome of antenatal hydronephrosis in babies born to mothers booked at SAT Hospital, detected on antenatal ultrasound (USS), in terms of persistence of renal anomalies, and to correlate the outcome with grade and laterality of antenatal hydronephrosis (ANH) Results: 99 babies with ANH were followed up till one year. Male:female ratio was 3.1:1. Major anomalies on postnatal evaluation were pelvi-ureteric junction obstruction (PUJO) (40,40.4%), Vesico ureteric reflux (VUR) (20,20.2%), Posterior urethral valve (PUV) (10,10.1%), Obstructed mega ureter (4,4%), Ureterocele (3,3 %). At 3 months hydronephrosis was transient in 22.2 (22/99) % and persistent in 77.8 (77/99) %. All (6/6) babies with grade 1 hydronephrosis and 43.2% (19/44) with grade 2 were transient. Factors associated with postnatal persistence were higher grade (p value<0.05) and bilateral hydronephrosis (p value<0.05). Conclusions: Idiopathic ANH is the most common renal abnormality detected by antenatal sonography. There was postnatal persistence of hydronephrosis beyond three months of age in 77.8%.Bilateral hydronephrosis showed higher chance of postnatal persistence. The outcome correlated with grade and laterality of antenatal hydronephrosis.

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