Clinical Outcome and Follow-up of Neonatal Hydronephrosis Diagnosed Antenatally

Park, Su-Eun; Kim, Su-Yung

J Korean Soc Pediatr Nephrol > Volume 2(2); 1998 > Article

J Korean Soc Pediatr Nephrol 1998;2(2): 161-168.

산전 진찰에서 진단된 신생아 수신증에 대한 추적 관찰

박수은, 김수영

¹부산대학교 의과대학 소아과학교실
²부산대학교 의과대학 소아과학교실

Clinical Outcome and Follow-up of Neonatal Hydronephrosis Diagnosed Antenatally

Su-Eun Park, Su-Yung Kim

¹Department of Pediatrics, Pusan National University, College of Medicine
²Department of Pediatrics, Pusan National University, College of Medicine

ABSTRACT

Purpose : Lots of congenital anomalies of urinary tract including hydronephrosis are detected in fetus and neworn by popular use of prenatal ultrasonography. But there are little data available in Korea about natural course of hydronephrosis diagnosed antenatally by ultrasonography. So we intended to help management of these patients by analizing the follow up data of the neonates with hydronephrosis diagnosed antenatally.
Methods : We evaluated 22 patients with neonatal hydronephrosis(33 renal units) who were diagnosed prenatally and confirmed postnatally. Especially patients with suspected ureteropelvic junction obstruction were followed regulary with renal ultrasonography and diuretic renography for 8-24 months.
Results : 1) The etiologies of neonatal hydronephrosis diagnosed prenatally were suspected ureteropelvic junction obstruction($69.9%$), vesicoureteral reflux($15.1%$), primary megaureter($3.0%$), double ureter with ureterocele($3.0%$), ureteral stricture($3.0%$), multicystic dysplastic kidney(3.0$%$), and ureterovesical junction obstruction(3.0$%$). 2) The follow up results of 23 renal units of suspected ureteropelvic junction obsruction: Except 4 renal units with palpable abdominal mass, of the remained 19 renal units, 14 units($73.6%$) were improved spontaneously, 3 units($15.7%$) remained stable, only2 units($10.5%$) were aggravated.
Conclusion : We concluded that in most cases of hydronephrosis there is no need for immediate surgery, and that nonoperative approach, using serial ultrasonography and diuretic renogram, is safe management of neonatal hydronephrosis diagnosed anteratally.

Key words: Hydronephrosis | Fetus | Children