ANTENATAL DIAGNOSIS OF HYDRONEPHROSIS AND ITS POSTNATAL OUTCOME

INTRODUCTION-Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound examination, affecting 1-5 percent of pregnancies. Despite its frequency, the appropriate postnatal management of prenatal hydronephrosis (PNH) is not well defined. Prenatal ultrasound identifies the whole spectrum including many children from the milder end, there by exposing them to excessive imaging both pre and postnatally. Prenatal hydronephrosis is diagnosed at an incidence of 1100 to 1500 by ultrasonographic studies. AIM-The aim of the study is to assess the outcome of fetal hydronephrosis postnatally. MATERIALS AND METHODS- Postnatal evaluation was uniformly done and the decision for intervention was made by a single pediatric surgeon. Based on the 32-week fetal ultrasound findings, patients were divided into two groups Group I (unilateral hydronephrosis) and group II (bilateral hydronephrosis). Statistical analysis was done using Fisher's exact test and Chi-square test and outcome was considered significant when the P value was less than 0.05. RESULTSAmong a total of 58 patients registered, 8 patients were excluded due to lack of follow up, leaving 50 in our study group. Out of 50 patients 34 patients were under Group I and 16 were under Group II. In Group I out of 34 patients 5 patients has undergone surgery (14.7) and in Group II out of 16 patients 11 patients has undergone surgery (68.7). Chi-square test is p is 0.02. DISCUSSION- Antenatal diagnosis of hydronephrosis causes significant distress to the parents during pregnancy. Lee et al 1 in their meta analysis on the outcome of antenatal hydronephrosis, have quoted that children with any degree of antenatal hydronephrosis are at a greater risk of postnatal pathology compared to normal population. Grignon et al 10 quoted that if the APD was more than 30 then 95 of the patients had a significant abnormality requiring surgery and long term follow up which is similar to our study.CONCLUSIONPostnatal outcome of ANTENATAL DIAGNOSIS OF HYDRONEPHROSIS AND ITS POSTNATAL OUTCOME SWETHA REDDY VIZA Department of Obstetrics and Gynaecology, PSG INSTITUTE OF MEDICAL SCIENCE & RESEARCH An Initiative of The Tamil Nadu Dr M.G.R. Medical University University Journal of Surgery and Surgical Specialities a fetal hydronephrosis is mainly dependent on the early detection continuous monitoring of the renal status and the APD diameter, timely intervention based on the disease improve the morbidity and prevent mortality.