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Evaluation and fetal intervention in severe fetal hydronephrosis
Adnan Safdar1, Kristianna Singh1, Raphael C Sun2
1Renal Section, Texas Children's Hospital, Baylor College of Medicine.
Current Opinion in Pediatrics
|March 2, 2021
Summary
Prenatal diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT) enables early fetal intervention for severe hydronephrosis. This can minimize adverse neonatal outcomes and long-term consequences.
Area of Science:
- Neonatal care
- Pediatric surgery
- Fetal medicine
Background:
- Congenital anomalies of the kidney and urinary tract (CAKUT) can lead to severe fetal hydronephrosis, impacting neonates post-birth.
- Prenatal diagnosis of CAKUT is crucial for timely intervention, potentially mitigating long-term health issues.
Purpose of the Study:
- To review fetal interventions for severe hydronephrosis secondary to CAKUT.
- To highlight the importance of early diagnosis and intervention in managing CAKUT.
Main Methods:
- Review of current literature on fetal intervention for CAKUT.
- Analysis of diagnostic criteria and outcomes for antenatal hydronephrosis (ANH).
Main Results:
- Despite diagnostic advancements, controversies exist in selecting ANH cases for fetal intervention.
- Fetal intervention is primarily used for lower urinary tract obstruction to support lung development via amniotic fluid restoration.
Conclusions:
- ANH can indicate the severity of renal anomalies but not specific diseases.
- A multidisciplinary approach is essential for diagnosing and staging severe CAKUT, with surgical intervention being a consideration.
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