Spontaneous rupture of fetal hydronephrosis: case report

Hydronephrosis is the most common congenital anomaly observed with prenatal ultrasonography. Ureteropelvic junction obstruction (UPJO) is the most common cause of prenatal hydronephrosis. Spontaneous rupture has been reported in adults with severe hydronephrosis. There is no reported spontaneous rupture case in the fetus in the literature. A spontaneous ureteral rupture due to severe UPJO was reported in this case report. Prenatal ultrasound at 33 week gestation in a 21-year-old pregnant woman, revealed a female fetus with grade IV hydronephrosis of the right kidney, suggestive of a UPJO. During the follow-up at XXXVIII week, 5 cm cystic structure was not observed in right kidney. Mild ectasia was present in pelvicalyciel part which make us think about spontaneous rupture. Ultrasonographic examination after a week post-delivery revealed 15 mm pelvicalyciel ectasia on right side which persisted during the second control after 1 month. Vesicoureteral reflux was not detected during voiding cystourethrogram. Diuretic renography revealed loss of right renal function completely. Because there was not any complain or any clinical sign, surgery was not thought. Spontaneous follow-up was recommended.