Antenatal hydronephrosis: an updated review on postnatal care and management

Antenatal hydronephrosis is the most common prenatally detected fetal anomaly and represents a spectrum of diseases from benign and self-limiting to significant uropathies. This review aims to provide an updated overview of antenatal hydronephrosis, organized by etiology, outlining epidemiology, diagnostic approach, and clinical implications of common and uncommon causes of hydronephrosis. We also explore management strategies, long-term kidney outcomes, and emerging research areas.

Novel research has focused on machine learning models to interpret imaging and predict the natural history of hydronephrosis and urinary tract dilation. Further studies aim to individualize care, reduce the use of antibiotic prophylaxis, and minimize the use of invasive imaging studies.

Categorizing and risk-stratifying the underlying etiology of antenatal hydronephrosis is important to understand the need for further work-up, select appropriate treatment options, and predict outcomes for patients affected by this broad spectrum of disease.