Perinatal Urinary Tract Dilation: Recommendations on Pre-/Postnatal Imaging, Prophylactic Antibiotics, and Follow-up:...

Area of Science:

• Pediatric Nephrology
• Prenatal Imaging
• Congenital Anomalies

Background:

• Perinatal urinary tract dilation (UTD) affects ~1% of pregnancies, being the second most common prenatal diagnosis.
• Causes range from transient dilation to vesicoureteral reflux (VUR) and obstruction, with most cases not requiring surgery.

Purpose of the Study:

• To review current imaging modalities for perinatal UTD.
• To discuss risk stratification, prophylactic antibiotic indications, and the utility of lower tract imaging and renal scintigraphy (RS).

Main Methods:

• Clinical report synthesizing current evidence and guidelines.
• Focus on imaging, risk assessment, and management strategies for UTD.

Main Results:

• Most UTD cases do not require surgical intervention.
• A subset of patients face risks for urologic and kidney disease, necessitating careful monitoring and management.

Conclusions:

• Individualized, evidence-based management involving shared decision-making is crucial for UTD.
• Immediate specialist consultation is advised for severe bilateral UTD in boys at high risk for bladder outlet obstruction.