European Journal of Cardiovascular Medicine

Objectives :  Fetal Hydronephrosis is a common condition which is routinely detected in ultrasound examination of antenatal mothers. Multiple conflicting prognostic factors have been mentioned in different literatures without any unanimous decision regarding its prognosis. The aim of this study is to assess the  outcome of this condition on the basis of third trimester ultrasound examination.   Materials  And Mathods :  On the basis of third trimester ultrasound examination, the patients were divided into group I (unilateral hydronephrosis) and group-II (bilateral hydronephrosis, ureteric dilatation, bladder wall thickening etc.).  Postnatal evaluation and follow-up was performed following a uniform protocol. Two outcomes, spontaneous resolution vs. surgical intervention, were compared between groups. These two groups were further subdivided in to subgroups . On the basis of third trimester ultrasound findings and further analysis was carried out.  Results :  A total number of 73 patients  with antenatal hydronephrosis   were included in this study. Group I had 59 patients and 10 (16%) required surgery; group II had 14 patients and 4 (28%) required surgery. The difference in outcome  between the groups was statistically  significant (p=0.01). The patients with unilateral hydronephrosis, none (0/59 ) with renal anteroposterior pelvic diameter (APD) < 15mm required surgery while, 2 out of 2 patients(2/2) with fetal APD >30 mm required surgery. In those with APD between 15-30 mm, 3 out of 8 (3/8) required surgery and prolonged follow-up was required to arrive at the decision. The difference in outcome between the subgroups was statistically significant( p=0.001, Chi-square test). Group II had two subgroups. Subgroup I consisted of patients with APD < 15mm with or without ureteric dilatation and bladder wall thickening , whereas subgroup II consisted of cases with APD >/= 15 mm with or without ureteric dilatation and bladder wall thickening. Of 10 cases in subgroup I, 1 (1/10) needed surgical intervention and 3 out of 4 cases(3/4) of subgroup II, needed surgery. The difference in outcome between these two groups was statistically significant( p=0.002, Chi-square test).= Conclusions: The results of our study shows that simple  unilateral fetal hydronephrosis runs a benign course. In the presence of hydronephrosis larger than 15 mm, bilateral disease or ureteric dilatation, detailed postnatal evaluation and regular follow-up is warranted to plan a timely intervention.