Fetal abnormalities » Urinary tract
- 1 in 500 births.
- Dilatation of the collecting system of the kidney observed in the standard transverse view of the abdomen. Ureters and bladder are normal.
- On the basis of the anteroposterior diameter of the pelvis the condition is divided into:
- Mild (only renal pelvis): 4-7 mm in the 2nd trimester; 7-9 mm in the 3rd.
- Moderate (pelvis and calyces): 8-10 mm in the 2nd trimester; 10-15 mm in the 3rd.
- Severe (cortical thinning): >10 mm in the 2nd trimester; >15 mm in the 3rd.
- Chromosomal defects: low risk in isolated forms.
- Abnormalities of the contralateral kidney: multicystic kidney, ectopia, renal agenesis.
- Associated syndromes are found in 5% of cases.
- Detailed ultrasound examination (especially of the contralateral kidney).
- Karyotyping should be offered only if other markers are present.
- Ultrasound scans every 4 weeks to monitor the evolution of hydronephrosis and assess amniotic fluid volume.
- Standard obstetric care and delivery.
- In the majority of cases, the condition remains stable or resolves in the neonatal period. In about 20% of cases, there may be an underlying ureteropelvic junction obstruction or vesicoureteric reflux that requires postnatal follow-up and possible surgery. Moderate hydronephrosis is usually progressive and in more than 50% of cases surgery is necessary during the first 2 years of life.
- Isolated: no increased risk of recurrence.