Clinical relevance and implications of antenatal hydronephrosis
a Department of Paediatric Nephrology,
Southmead Hospital, Westbury on Trym, Bristol, b Department of Urology, c Department of Radiology
Correspondence to: Dr JA Dudley.
Accepted 22 October 1996
Detailed antenatal sonography was performed on 18 766 pregnant
women between 1990 and 1994. Antenatal hydronephrosis, defined as an
antero-posterior diameter of the renal pelvis (APPD) greater than 5 mm,
was detected in 100 cases (0.59%). Sixty four infants had postnatal
hydronephrosis at one and/or six weeks after delivery; 21 of these had
urological anomalies.
Twelve infants had vesico-ureteric reflux. In all refluxing units the
APPD of the renal pelvis was less than 10 mm. Three patients had
obstruction at the pelvi-ureteric junction (PUJ); all required surgery.
Vesico-ureteric reflux is emerging as the most common urological
finding in infants with antenatal hydronephrosis and is likely to be
missed if kidneys with APPD of less than 10 mm are not further
investigated. In contrast, pelvi-ureteric junction obstruction may be
overdiagnosed, based only on drainage patterns of dynamic renogram studies.
© 1997 by Archives of Disease in Childhood
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