Fetal hydronephrosis: principles of management of patients in the postnatal period. A review

Abstract

Introduction: before the development and widespread of antenatal ultrasound, most of urologic anomalies were diagnosed only when they were symptomatic or complicated. Since the late 1970s, prenatal screening with ultrasound has become a routine component of care for pregnant women worldwide. Fetal hydronephrosis (FH) is the most common urogenital anomaly detected, suggesting that an obstructive process may be potentially present. Relevance: FH represents a spectrum, with most cases being a trivial and inconsequential finding on fetal ultrasound. Mild FH will often resolve spontaneously, whereas moderate to severe FH is frequently associated with congenital anomalies of the kidney and urinary tract. The differential diagnosis of FH is quite broad. It includes ureteropelvic junction obstruction, vesicoureteral reflux, posterior urethral valves, ureterocele or other anomalies. Purpose of review: over the last decade, recommendations for postnatal evaluation of these abnormalities have been under intense investigation. A large cohort studies have resulted in significant changes in current principles of care. The aim of this review is to provide an overview of the management of children with FH.