Zia BB, Lisseter R, Niyogi A, et al. First postnatal ultrasound scan to predict the outcome of antenatally diagnosed hydronephrosis. Series Surg Intensive Care Med. 2025;1(1):1-9.
Purpose: To determine if anteroposterior renal pelvic diameter (APD) on the first postnatal ultrasound (US) scan can predict outcomes in children with antenatal hydronephrosis (ANH).
Method: Data on all babies with ANH born in our center from 2009–2015 was obtained from the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS). The medical records were reviewed. Statistical analysis was performed on GraphPad.
Results: 223 babies were included in the study. 165 (74%) had spontaneous resolution of hydronephrosis. The mean APD on the first US was 13.3 mm in children whose ANH was resolved and 25.3 mm in those with persistent ANH (p < 0.01). 50 procedures were performed on 37 children. The most common procedure was pyeloplasty (n = 15), followed by total or partial nephroureterectomy (n = 12). 21 children had persistent dilatation but needed no intervention. Renal duplex (n = 8) was the most common diagnosis in this group (persistent dilatation) followed by vesicoureteric reflux (VUR) (n = 7). All babies with APD > 24 mm on their first US required surgical intervention.
Conclusion: While most ANH resolves spontaneously, children with higher APD in the first US have a higher likelihood of subsequent surgery. All children with APD > 24 mm require surgery. This information is beneficial in postnatal counseling for children with ANH.
