Safe discharge parameters for patients with isolated antenatal hydronephrosis

Area of Science:

• Pediatric Urology
• Fetal Medicine
• Diagnostic Imaging

Background:

• Antenatal hydronephrosis is a common finding on routine fetal ultrasonography, leading to frequent urology referrals.
• Current follow-up guidelines for isolated antenatal hydronephrosis are lacking, creating uncertainty in patient management.

Purpose of the Study:

• To establish safe parameters for early discharge of patients with antenatal hydronephrosis.
• To minimize unnecessary follow-up appointments and associated healthcare burdens.

Main Methods:

• Retrospective review of patients with isolated antenatal hydronephrosis (2010-2012).
• Analysis of progression based on initial and follow-up anterior-posterior diameter (APD) measurements.
• Comparison of outcomes between APD < 10 mm and APD ≥ 10 mm groups, stratified by SFU grade.

Main Results:

• Most patients (186) and renal units (308) had APD < 10 mm, predominantly SFU grades 0-2 (92.1%).
• Renal units with APD ≥ 10 mm were more likely to be SFU grades 3-4 (60%) and showed a higher likelihood of progression (7.76 times more likely).
• Pyeloplasty was performed only on SFU grades 3-4, all in the APD ≥ 10 mm group.

Conclusions:

• Initial postnatal APD ≥ 10 mm with SFU grade 3-4 warrants continued follow-up.
• Patients with APD < 10 mm, especially SFU grades 1-2, can be safely discharged, as complications are unlikely.