How is prenatal hydronephrosis treated?

How is prenatal hydronephrosis treated?

Prenatal hydronephrosis is often treated with antibiotics to prevent kidney infections. The specific antibiotics used have very few side effects. In a small portion of cases, usually grade IV prenatal hydronephrosis, surgery may be needed to correct the problem.

What is antenatal hydronephrosis?

What is antenatal hydronephrosis? Antenatal (before birth) hydronephrosis (fluid-filled enlargement of the kidney) can be detected in a fetus by ultrasound as early as the first trimester of a pregnancy. During pregnancy, this condition is identified in 1 percent of males and 0.5 percent of females.

How serious is hydronephrosis?

Left untreated, severe hydronephrosis can lead to permanent kidney damage. Rarely, it can cause kidney failure. But hydronephrosis typically affects only one kidney and the other kidney can do the work for both.

Why do people get hydronephrosis?

Hydronephrosis is swelling of one or both kidneys. Kidney swelling happens when urine can’t drain from a kidney and builds up in the kidney as a result. This can occur from a blockage in the tubes that drain urine from the kidneys (ureters) or from an anatomical defect that doesn’t allow urine to drain properly.

What is the main cause of hydronephrosis?

Hydronephrosis is usually caused by a blockage in the urinary tract or something disrupting the normal workings of the urinary tract. The urinary tract is made up of the kidneys, the bladder, the ureters (the tubes that run from the kidney to the bladder) and the urethra (the tube that carries urine out of the body).

When to do an antenatal ultrasound for hydronephrosis?

The antenatal ultrasound screening is most commonly performed at 18-20 wk of gestation. This is the time when the renal architecture becomes visibly distinct. Normally the renal pelvis and calyces are not seen, if seen then it indicates hydronephrosis.

Is there a classification system for antenatal hydronephrosis?

In 1990, Mandell proposed a classification system based on APD and gestational age that helps to categorize antenatal hydronephrosis in the mild, moderate and severe variety [ 9 ].

What is the definition of hydronephrosis postnatally?

The diagnosis of fetal pelvis dilatation and its natural history postnatally is best understood if we understand that the definition of hydronephrosis has undergone a sea change. Traditionally hydronephrosis was defined as dilatation of the pelvicalyceal system due to partial or complete obstruction.

How big is APD at 20 wk for hydronephrosis?

A number of other studies have noted persistent postnatal uropathy when the APD measures > 6 mm at < 20 wk, > 8 mm at 20-30 wk and > 10 mm at > 30 wk gestation [ 13, 14 ]. Recently cut off of 6 mm at 20 wk and 10 mm at 30 wk have been suggested for pyelectasis and an APD cut off of 10 mm at 20 wk and 12 mm at 30 wk for hydronephrosis [ 15 ].