The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis.
OBJECTIVE
To evaluate the effectiveness of the first postnatal ultrasound (US) in predicting the final postnatal diagnosis using a database of children followed prospectively for antenatal hydronephrosis, and to compare these findings with a systematic review of the literature.


METHODS
The study involved 1441 children who had their radiological evaluation between 3 and 60 days of life, including an US, performed at our institution in 1998-2006. Univariate and multivariate analyses were performed. A systematic review of articles on prenatal hydronephrosis resulted in 31 studies with 2202 patients who met the inclusion criteria for analysis.


RESULTS
62.0% of renal units (RUs) had transient or non-obstructive hydronephrosis. Increasing degree of hydronephrosis correlated with increased risk of urological pathologies (from 29.6% RUs in the mild group to 96.3% RUs in the severe group). A systematic review of the literature indicated very poor quality data, but the findings appeared to be concordant with those from our patient population.


CONCLUSIONS
The findings from this study will help to quantify the incidence of postnatal pathology based upon the first postnatal US parameters. This information is useful for counseling and for determining which postnatal radiological tests will be necessary.
Passerotti
Carlo C
CC
Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Kalish
Leslie A
LA
Chow
Jeannie
J
Passerotti
Ana Maria A M S
AM
Recabal
Pedro
P
Cendron
Marc
M
Lee
Richard S
RS
Lopez
Arielle Bressler
AB
Retik
Alan B
AB
Nguyen
Hiep T
HT
D016208:Databases, Factual; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012196:Review Literature as Topic; D012307:Risk Factors; D014463:Ultrasonography