Prenatal Hydronephrosis Overview

Prenatal hydronephrosis, characterized by dilation of the renal pelvis in a fetus, is a common finding in routine ultrasounds, affecting approximately 1% to 4.5% of pregnancies. (pubmed.ncbi.nlm.nih.gov)

Postnatal Management

After birth, the management of hydronephrosis depends on its severity and persistence:

• Mild Cases: Often resolve spontaneously without intervention. (pubmed.ncbi.nlm.nih.gov)

• Moderate to Severe Cases: May require surgical intervention, such as pyeloplasty, especially if there's evidence of obstruction or declining renal function. (pubmed.ncbi.nlm.nih.gov)

Ongoing Issues

The likelihood of persistent hydronephrosis decreases with its severity:

• Mild Hydronephrosis: Approximately 65% to 90% resolve without intervention. (pmc.ncbi.nlm.nih.gov)

• Moderate to Severe Hydronephrosis: Higher rates of persistence, with surgical intervention required in about 15% to 65% of cases. (bmcurol.biomedcentral.com)

Prenatal Steps Before Diagnosis

Prenatal detection of hydronephrosis typically involves routine ultrasounds performed during pregnancy. If hydronephrosis is identified, further evaluation may include:

• Assessment of Severity: Measuring the anteroposterior diameter of the renal pelvis.

• Evaluation for Associated Anomalies: Checking for vesicoureteral reflux or other structural abnormalities. (sciencedirect.com)

Early consultation with pediatric urologists can aid in planning postnatal management strategies. (frontiersin.org)

In summary, while prenatal hydronephrosis is common and often resolves without intervention, careful postnatal monitoring is essential to identify cases that may require treatment.