Outcome of fetal renal pelvic dilatation diagnosed during the third trimester.
OBJECTIVE
The aim of this study was to evaluate renal function and the need for postnatal treatment--antibiotic therapy and/or surgery--in relation to the grade of fetal renal pelvic dilatation (RPD) found on third-trimester ultrasound examination.


METHODS
The retrospective study included 78 children, born between 1995 and 2000, with 115 dilated fetal renal pelvic units. The children were allocated to three groups based on pelvic anteroposterior diameter (APD) detected on third-trimester ultrasound: APDs of 7-9.9 mm, 10-14.9 mm and > or = 15 mm were classified as mild dilatation, moderate hydronephrosis and severe hydronephrosis, respectively. Renal function was assessed by scintigraphy.


RESULTS
None of the 20 children with mild dilatation experienced a urinary tract infection (UTI) or underwent surgery; two had associated renal or urinary tract abnormalities. In contrast, five out of 22 (23%) children with moderate hydronephrosis and 23 out of 36 (64%) with severe hydronephrosis had either a UTI or required surgery (P < 0.001); associated abnormalities were also more common (6 out of 22 and 15 out of 36, respectively). There was no significant correlation between the grade of antenatal RPD and postnatal ipsilateral renal function.


CONCLUSIONS
The need for postnatal treatment increased significantly with the grade of antenatal RPD. Children with antenatal mild dilatation were discharged early from follow-up whereas those with moderate and severe fetal hydronephrosis needed close follow-up by a multidisciplinary team.
Wollenberg
A
A
Department of Obstetrics, University Hospital Zurich, Switzerland.
Neuhaus
T J
TJ
Willi
U V
UV
Wisser
J
J
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004108:Dilatation, Pathologic; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018579:Patient Selection; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
D000900:Anti-Bacterial Agents