Editing CUA: Antenatal hydronephrosis (2017) (section)

== Antenatal vs. post-natal follow-up ==

* '''Frequency of antenatal follow-up of a pregnant mother is at the discretion of the obstetrician'''
* '''<span style="color:#ff0000">Second trimester antenatal hydronephrosis is often followed up so that progression of severity can be detected and appropriate postnatal follow-up planned'''
* '''<span style="color:#ff0000">Most centers define significant antenatal hydronephrosis in the third trimester as APD ≥7 mm'''
** Although APD >4‒5 mm in the third trimester is considered pyelectasis, the ideal cut-off for routine postnatal screening remains controversial, since high grades of AHN can resolve postnatally and conversely low grades can deteriorate
* '''<span style="color:#ff0000">Indications for referral to a pediatric urologist for antenatal counselling'''
**'''<span style="color:#ff0000">If antenatal fetal ultrasound (5):'''
**# '''<span style="color:#ff0000">Dilated bladder'''
**# '''<span style="color:#ff0000">History of oligohydramnios'''
**# '''<span style="color:#ff0000">Severe bilateral hydronephrosis'''
**# '''<span style="color:#ff0000">Increased renal cortical echogenicity''' (hyper-echogenicity)
**# '''<span style="color:#ff0000">Renal cortical cysts'''
*** '''<span style="color:#ff0000">These findings raise concern for potential renal failure'''
* '''Karyotype'''
**'''Routine karyotyping for all cases of isolated antenatal hydronephrosis is not recommend'''
***May be considered in the presence of multiple system anomalies.
****Antenatal hydronephrosis is more common in fetuses with serious chromosomal anomalies