How is Antenatal Hydronephrosis Diagnosed and Monitored?

Antenatal Hydronephrosis is a condition where a fetus develops kidney swelling due to urine buildup. It is commonly diagnosed via prenatal ultrasound. While some cases resolve on their own, others require close monitoring and intervention. Understanding how Antenatal Hydronephrosis diagnosed and monitored is essential for parents and healthcare providers.

What is Antenatal Hydronephrosis?

Antenatal hydronephrosis refers to the dilatation of the renal pelvis in the fetus, which can be detected through routine ultrasound scans. This condition occurs when outflow of urine from the kidneys to the ureter is obstructed or slowed down.

Investigations done for Antenatal Hydronephrosis

1. Prenatal Ultrasound : The primary method for diagnosing antenatal hydronephrosis is through a prenatal ultrasound performed during pregnancy. This imaging test helps detect any swelling in the fetal kidneys and measure the degree of dilation and monitor the swelling throughout the pregnancy.

2. Amniotic Fluid Assessment : Ultrasound can also tell us about the amniotic fluid levels since reduced amniotic fluid along with hydronephrosis can indicate severe urinary tract obstruction. Proper fluid levels are essential for fetal kidney function and lung development.

3. Postnatal Ultrasound : Once the baby is born, a follow-up postnatal ultrasound is performed between 7-10 days of life. This helps confirm whether the hydronephrosis persists or has resolved. In cases of bilateral severe hydronephrosis, early ultrasound within the first 48 hours of life is advised.

4. Voiding Cystourethrogram (VCUG) : If postnatal ultrasound shows persistent hydronephrosis along with dilatation of the ureter or the child has recurrent urinary tract infection, a VCUG test may be conducted to check for vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder to the kidneys.

5. Nuclear Renal Scan (DMSA or EC Scan) : A renal scan helps assess kidney function, detect any blockages in the urinary tract and assess any scars in the kidneys. EC scan is done to rule out PUJ obstruction or VUJ obstruction and DMSA is done in cases of VUR(vesicoureteric reflux) to check the scars in the kidney.

When to Seek Medical Attention?

Parents should consult a pediatric nephrologist or urologist if hydronephrosis was seen in antenatal scans even if child is asymptomatic after birth or if their baby experiences:

FAQs About Antenatal Hydronephrosis

1. Is antenatal hydronephrosis a serious condition?

Not always. Many mild cases resolve on their own, but severe cases require close monitoring and possible intervention.

2. How often should antenatal hydronephrosis be monitored?

Monitoring frequency depends on severity. Mild cases require routine ultrasounds, while severe cases need further evaluation in the form of MCU and nuclear renal scans.

3. Can antenatal hydronephrosis affect kidney function?

If left untreated in severe cases, it may impact kidney function. However, early diagnosis and treatment help prevent complications.

4. Does antenatal hydronephrosis always require surgery?

No, surgery is only needed in symptomatic cases or in significant urinary obstruction as seen on ultrasound and nuclear scans.

5. Where can I get expert care for antenatal hydronephrosis in Navi Mumbai?