Volume 13, Issue 51 (10-2004)                   jour guilan uni med sci 2004, 13(51): 73-77 | Back to browse issues page

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Safaei Asl A. Study On Neonates and Infants With Prenatal Hydronephrosis. jour guilan uni med sci. 2004; 13 (51) :73-77
URL: http://journal.gums.ac.ir/article-1-657-en.html
Abstract:   (11328 Views)
Abstract Introduction: Over the past two decades, the routine use of maternal-fetal ultrasound has spawned the field of prenatal nephrology and urology. The most common entity studied is prenatal hydronephrosis. which is diagnosed with an incidence of 1:100 to 1:500 Objective: In this study, the postnatal diagnoses of 21 patients with prenatal hydronephrosis were investigated. Materials and Methods: In this study, postnatal results of the prenatal hydronephrosis that were reported in the second trimester of pregnancy were discussed. For the child with bilateral hydronephrosis, an ultrasound examination was performed immediately after birth and if the bilateral hydronephrosis suggestive of bladder outlet obstruction a VCUG was performed before discharge of hospital. The child with unilateral hydronephrosis was treated with prophylactic antibiotic and then an ultrasound examination was performed at 4 weeks of age. If the ultrasound at 4 week demonstrated moderate or severe hydronephrosis a VCUG and DTPA scan were performed. Results: Twenty-one neonates and infants were investigated. Boys were more commonly affected than girls(ratio2:1). In sixteen cases, hydronephrosis was unilateral and in five patients, hydronephrosis was unilateral. In patients with bilateral hydronephrosis, two patients had posterior urethral valve and in one case, multicystic displastic kidney with reflux of opposite kidney was seen. One patient had bilateral partial obstruction in urethropelvic junction. Other patient had ipsilateral UPJO with UVJO in opposite kidney. In patients with unilateral hydronephrosis, 11 patients had UPJ obstruction. Multicystic dysplastic kidney was seen in two patients and reflux in two other patients and UVJO was seen in one patient. At last, 5 patients underwent surgical procedure due to decline of renal function and thinning of renal cortex in serial scan and sonography. Conclusion: Neonates with prenatal hydronephrosis should be carefully evaluated and followed by a pediatric nephrologist and urologist. Although upj obstruction is the most common cause of hydronephrosis in children but voiding cystography in these patients is necessary. These patients require close follow up to ensure that renal function and development are not affected.
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Type of Study: Research | Subject: General
Received: 2014/07/8 | Accepted: 2014/07/8 | Published: 2014/07/8

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