Fetal hydronephrosis

Abstract

Antental intervention in cases where the foetus was suspected of having hydronephrosis has been the subject of intense discussion in recent years where the diagnosis was technically possible. The object of this investigation was to assess the end result in foetuses with hydronephrosis diagnosed prenatally and who were treated expectantly without intervention in utero. Fourteen consecutive cases of suspected foetal hydronephrosis are described. In four of the cases the hydronephrosis was transient without consequences for subsequent renal function. Three infants died, however, immediately after birth. All three were shown to have multiple malformations and/or chromosome anomalies. Unilateral dilatation of the upper urinary tract (seven cases) was by and large, associated with a good prognosis. Foetuses with bilateral dilatation of the upper urinary tract (seven cases) had poorer prognoses but this might also be related to other serious malformations. If this is compared with the disappointing result obtained by prenatal intervention in the form of foetal surgery or introduction of vesico-amniotic stents, very little evidence is found in favour of in utero intervention. In the great majority of cases, conservative prenatal regime is preferable.