The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis

Passerotti, Carlo C.; Kalish, Leslie A.; Chow, Jeannie; Passerotti, Ana Maria A.M.S.; Recabal, Pedro; Cendron, Marc; Lee, Richard S.; Lopez, Arielle Bressler; Retik, Alan B.; Nguyen, Hiep T.

doi:10.1016/j.jpurol.2010.09.007

« Previous Next »Journal of Pediatric Urology
Volume 7, Issue 2 , Pages 128-136, April 2011

The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis

Carlo C. Passerotti
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Leslie A. Kalish
- Clinical Research Program, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115, USA
Jeannie Chow
- Department of Radiology, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115, USA
Ana Maria A.M.S. Passerotti
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Pedro Recabal
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Marc Cendron
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Richard S. Lee
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Arielle Bressler Lopez
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Alan B. Retik
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
Hiep T. Nguyen
- Department of Urology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Hunnewell-353, Boston, MA 02115, USA
- Corresponding author. Tel.: +1 617 355 3341; fax: +1 617 730 0474.

Received 24 July 2010; accepted 7 September 2010. published online 18 October 2010.

Abstract

Objective

To evaluate the effectiveness of the first postnatal ultrasound (US) in predicting the final postnatal diagnosis using a database of children followed prospectively for antenatal hydronephrosis, and to compare these findings with a systematic review of the literature.

Methods

The study involved 1441 children who had their radiological evaluation between 3 and 60 days of life, including an US, performed at our institution in 1998–2006. Univariate and multivariate analyses were performed. A systematic review of articles on prenatal hydronephrosis resulted in 31 studies with 2202 patients who met the inclusion criteria for analysis.

Results

62.0% of renal units (RUs) had transient or non-obstructive hydronephrosis. Increasing degree of hydronephrosis correlated with increased risk of urological pathologies (from 29.6% RUs in the mild group to 96.3% RUs in the severe group). A systematic review of the literature indicated very poor quality data, but the findings appeared to be concordant with those from our patient population.

Conclusion

The findings from this study will help to quantify the incidence of postnatal pathology based upon the first postnatal US parameters. This information is useful for counseling and for determining which postnatal radiological tests will be necessary.

Keywords: Antenatal hydronephrosis, Postnatal ultrasound, Diagnosis