Antenatal hydronephrosis and fetal urine sampling

Area of Science:

• Perinatology
• Fetal Medicine
• Pediatric Urology

Background:

• Antenatal hydronephrosis (AHN) is a common finding in fetal ultrasound.
• Accurate assessment of fetal renal function is critical for management decisions.
• Intrauterine interventions for AHN require careful patient selection.

Purpose of the Study:

• To evaluate the diagnostic significance of renal pelvis aspiration (RPA) in managing AHN.
• To assess the utility of fetal urine analysis in predicting renal function.
• To identify key biomarkers for selecting fetuses requiring intervention.

Main Methods:

• Retrospective analysis of 15 AHN cases requiring RPA.
• Exclusion of chromosomal and severe congenital abnormalities before intervention.
• Urine analysis including sodium and β2-microglobulin levels.
• Group comparison based on renal function post-intervention.

Main Results:

• 40% of cases (Group 1) showed normal renal function; 60% (Group 2) had impaired function and urinary anomalies.
• Significant differences between groups in oligohydramnios, fetal urine sodium, β2-microglobulin, gestational age at birth, and birth weight.
• Fetal urine sodium and β2-microglobulin levels were significantly higher in the impaired renal function group.

Conclusions:

• RPA and urine analysis are valuable tools for AHN management.
• Fetal urine sodium and β2-microglobulin are effective biomarkers for detecting severe renal damage.
• These markers aid in selecting fetuses for appropriate antenatal interventions.