Related Experiment Video
Updated: Aug 9, 2026
Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
Outcome of fetal renal pelvic dilatation diagnosed during the third trimester
A Wollenberg1, T J Neuhaus, U V Willi
1Department of Obstetrics, University Hospital Zurich, Switzerland.
Insights
Fetal renal pelvic dilatation (RPD) grade on ultrasound predicts postnatal treatment needs. Mild RPD requires minimal follow-up, while moderate to severe cases necessitate close monitoring for urinary tract infections and potential surgery.
Area of Science:
- Pediatric Nephrology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Prenatal diagnosis of fetal renal pelvic dilatation (RPD) is common.
- The clinical significance of RPD grade requires further elucidation.
- Predicting postnatal outcomes is crucial for effective management.
Purpose of the Study:
- To assess the correlation between fetal RPD grade and the requirement for postnatal interventions.
- To evaluate renal function in relation to RPD severity.
- To determine the necessity of antibiotic therapy and/or surgery based on antenatal ultrasound findings.
Main Methods:
- Retrospective analysis of 78 children with 115 dilated fetal renal pelvic units.
- Classification of RPD into mild, moderate, and severe based on anteroposterior diameter (APD) on third-trimester ultrasound.
- Renal function assessment using scintigraphy.
Main Results:
- No urinary tract infections (UTIs) or surgeries occurred in the mild RPD group (n=20).
- Moderate (n=22) and severe (n=36) RPD groups showed significantly higher rates of UTI or surgery (23% and 64%, respectively; P < 0.001).
- No significant correlation was found between antenatal RPD grade and postnatal renal function.
Conclusions:
- Postnatal treatment necessity escalates with increasing RPD grade.
- Children with mild antenatal RPD can be discharged early from follow-up.
- Moderate and severe fetal hydronephrosis warrant close multidisciplinary team follow-up.
Objectives:
The aim of this study was to evaluate renal function and the need for postnatal treatment--antibiotic therapy and/or surgery--in relation to the grade of fetal renal pelvic dilatation (RPD) found on third-trimester ultrasound examination.
Methods:
The retrospective study included 78 children, born between 1995 and 2000, with 115 dilated fetal renal pelvic units. The children were allocated to three groups based on pelvic anteroposterior diameter (APD) detected on third-trimester ultrasound: APDs of 7-9.9 mm, 10-14.9 mm and > or = 15 mm were classified as mild dilatation, moderate hydronephrosis and severe hydronephrosis, respectively. Renal function was assessed by scintigraphy.
Results:
None of the 20 children with mild dilatation experienced a urinary tract infection (UTI) or underwent surgery; two had associated renal or urinary tract abnormalities. In contrast, five out of 22 (23%) children with moderate hydronephrosis and 23 out of 36 (64%) with severe hydronephrosis had either a UTI or required surgery (P < 0.001); associated abnormalities were also more common (6 out of 22 and 15 out of 36, respectively). There was no significant correlation between the grade of antenatal RPD and postnatal ipsilateral renal function.
Conclusions:
The need for postnatal treatment increased significantly with the grade of antenatal RPD. Children with antenatal mild dilatation were discharged early from follow-up whereas those with moderate and severe fetal hydronephrosis needed close follow-up by a multidisciplinary team.
Related Concept Videos
01:26Nursing Assessment of the Genitourinary System II: Inspection and Palpation
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:30Urinary Tract Calculi III: Medical Management
01:26Kidney Transplant II: Surgical Procedure
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography