Postnatal follow-up of antenatal hydronephrosis: a health-care challenge.
OBJECTIVE
To examine our experience with ANH and to determine the success of our postnatal follow-up program.


METHODS
Charts of mothers and infants seen (2004 to 2008) at our Regional Perinatal Center were reviewed retrospectively. ANH was defined during the third trimester by anterior pelvic diameters as follows: mild 7 to 9, moderate 10 to 14 or severe >or=15 mm. Fetuses with multicystic dysplastic kidney (MCDK) were included.


RESULTS
Screening of approximately 15 000 ultrasound (US) reports identified 268 fetuses with ANH. After prenatal US surveillance, 88 (33%) fetuses had resolved, while 180 (67%) required postnatal follow-up. These 180 fetuses were diagnosed with mild 38 (21%), moderate 83 (46%) and severe 19 (11%) ANH, uni or bilateral hydroureters 12 (7%), MCDK 19 (10%) and miscellaneous 9 (5%). Postnatal follow-up was successfully established for 75% of infants with hydroureters, 68% for those with MCDK and for 37% of infants with mild, 53% with moderate and 58% with severe ANH. Factors commonly known to influence compliance were not found more frequently among the 91 infants who were lost to follow-up. The only positive predictor for postnatal follow-up was a prenatal consultation with the pediatric urologist.


CONCLUSIONS
Our antepartum program for diagnosis of ANH is accessible and efficient; however, there was an unacceptably high number of infants lost to follow-up. The absence of traditional barriers for compliance highlights the need to explore new ways of improving postnatal follow-up of infants with ANH.
Cordero
L
L
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210-1228, USA. leandro.cordero@osumc.edu
Nankervis
C A
CA
Oshaughnessy
R W
RW
Koff
S A
SA
Giannone
P J
PJ
D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D015997:Neonatal Screening / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011181:Postnatal Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014481:United States