title: Incidence and outcomes of antenatally detected congenital hydronephrosis.
abstract: OBJECTIVE
  Antenatally detected urinary tract abnormalities (ADUTA) are increasingly recognized. Our aims were to determine the incidence and outcomes of antenatally diagnosed congenital hydronephrosis in a large cohort.
  
  
  METHODS
  We recorded the number of total deliveries over 4 years at King Abdulaziz University Hospital (KAUH) between January 2008 and December 2011 from the number of nursery and neonatal intensive care unit (NICU) admissions.
  
  
  METHODS
  We reviewed the records of 18 853 deliveries between January 2008 and December 2011 at KAUH, Saudi Arabia. ADUTA were recorded, and their postnatal medical records were reviewed for demographic and radiological data.
  
  
  RESULTS
  ADUTA were diagnosed in 327 fetuses (1.7%). The commonest pathology was congenital hydronephrosis (n=313, 95.7%). Cystic renal anomalies were reported in 4 babies (1.2%), and 10 children (3.1%) were reported to have other renal anomalies, including duplex kidneys or a single kidney. A total of 240 babies with congenital hydronephrosis were followed up. Hydronephrosis resolved in 99 children (41.2%) within 2 months of birth. A total of 29 subjects had underlying renal anomalies (12.1%), including vesicoureteral reflux (n=12, 5%), pelvi-ureteric junction obstruction (n=14, 5.8%), and posterior urethral valve (n=3, 1.3%). The best predictor for nonresolving congenital hydronephrosis and underlying anatomical abnormalities was the anteroposterior diameter on the first postnatal scan. A cut-off point of 5 mm was found to be 83% sensitive in predicting nonresolving hydronephrosis, while 7 mm was 88% sensitive and 10 mm was 94% sensitive.
  
  
  CONCLUSIONS
  Congenital hydronephrosis is the commonest ADUTA. A large percentage resolved within 2 months of birth, but underlying anatomical abnormalities were found in 12.1%. All babies with antenatally detected hydronephrosis should be examined by ultrasound postnatally but further radiological investigations should only be performed for persistent significant AP dilatation >=10 mm.
authors.affiliation: Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia. jkari@doctors.org.uk
authors.forename: Jameela Abdulaziz
authors.initials: JA
authors.lastname: Kari
authors.forename: Saddiq
authors.initials: S
authors.lastname: Habiballah
authors.forename: Saad A
authors.initials: SA
authors.lastname: Alsaedi
authors.forename: Hussain
authors.initials: H
authors.lastname: Alsaggaf
authors.forename: Amal
authors.initials: A
authors.lastname: Al-dabbagh
authors.forename: Adila
authors.initials: A
authors.lastname: AbulHamail
authors.forename: Adel
authors.initials: A
authors.lastname: Marzouki
authors.forename: Basem
authors.initials: B
authors.lastname: Eldeek
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012529:Saudi Arabia; D012680:Sensitivity and Specificity; D013997:Time Factors; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014551:Urinary Tract / Q000002:abnormalities / Q000000981:diagnostic imaging*