New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study
Background: Antenatal hydronephrosis (ANH) is a common prenatal finding that requires careful evaluation to determine appropriate management strategies. The variability in outcomes underscores the need for refined diagnostic and monitoring protocols to differentiate between cases necessitating inter...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-08-01
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| Series: | Journal of Pharmacy and Bioallied Sciences |
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| Online Access: | https://journals.lww.com/10.4103/jpbs.jpbs_412_24 |
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| author | Rana P. Singh Shyam S. Sahu Abhishek Kumar Singh Rajiv Ranjan |
| author_facet | Rana P. Singh Shyam S. Sahu Abhishek Kumar Singh Rajiv Ranjan |
| author_sort | Rana P. Singh |
| collection | DOAJ |
| description | Background:
Antenatal hydronephrosis (ANH) is a common prenatal finding that requires careful evaluation to determine appropriate management strategies. The variability in outcomes underscores the need for refined diagnostic and monitoring protocols to differentiate between cases necessitating intervention and those likely to resolve spontaneously.
Materials and Methods:
A prospective clinical study was conducted involving 150 pregnant women diagnosed with ANH between gestational weeks 18 to 24. Prenatal ultrasounds were performed at regular intervals to monitor renal pelvic dilatation. Postnatal evaluations included renal ultrasound, voiding cystourethrography, and nuclear renal scans to assess renal function and identify associated anomalies. Management decisions were based on standardized criteria including degree of hydronephrosis, presence of associated anomalies, and renal function.
Results:
Of the 150 cases, 80 (53.3%) resolved spontaneously during the prenatal period, while 70 (46.7%) required postnatal intervention. Among the intervention group, 45 cases (64.3%) required surgical correction for persistent hydronephrosis or associated anomalies, while the remaining 25 cases (35.7%) were managed conservatively with close monitoring. Arbitrarily, the mean anteroposterior renal pelvic diameter (APRPD) in the resolved group was 5.2 mm, compared to 10.6 mm in the intervention group. The median postnatal follow-up duration was 24 months.
Conclusion:
This study highlights the importance of systematic evaluation and monitoring in managing ANH. While a significant proportion of cases resolve spontaneously, a careful assessment of associated anomalies and renal function is crucial in identifying cases requiring intervention. The arbitrary APRPD values presented underscore the potential for establishing diagnostic thresholds to guide clinical decision-making. Refinement of treatment protocols based on such parameters can improve outcomes and reduce unnecessary interventions in infants with ANH. |
| format | Article |
| id | doaj-art-434c7c7a11274c198ece62dc99536bd2 |
| institution | OA Journals |
| issn | 0976-4879 0975-7406 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Pharmacy and Bioallied Sciences |
| spelling | doaj-art-434c7c7a11274c198ece62dc99536bd22025-08-20T01:48:07ZengWolters Kluwer Medknow PublicationsJournal of Pharmacy and Bioallied Sciences0976-48790975-74062024-08-0116Suppl 3S2848S285010.4103/jpbs.jpbs_412_24New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical StudyRana P. SinghShyam S. SahuAbhishek Kumar SinghRajiv RanjanBackground: Antenatal hydronephrosis (ANH) is a common prenatal finding that requires careful evaluation to determine appropriate management strategies. The variability in outcomes underscores the need for refined diagnostic and monitoring protocols to differentiate between cases necessitating intervention and those likely to resolve spontaneously. Materials and Methods: A prospective clinical study was conducted involving 150 pregnant women diagnosed with ANH between gestational weeks 18 to 24. Prenatal ultrasounds were performed at regular intervals to monitor renal pelvic dilatation. Postnatal evaluations included renal ultrasound, voiding cystourethrography, and nuclear renal scans to assess renal function and identify associated anomalies. Management decisions were based on standardized criteria including degree of hydronephrosis, presence of associated anomalies, and renal function. Results: Of the 150 cases, 80 (53.3%) resolved spontaneously during the prenatal period, while 70 (46.7%) required postnatal intervention. Among the intervention group, 45 cases (64.3%) required surgical correction for persistent hydronephrosis or associated anomalies, while the remaining 25 cases (35.7%) were managed conservatively with close monitoring. Arbitrarily, the mean anteroposterior renal pelvic diameter (APRPD) in the resolved group was 5.2 mm, compared to 10.6 mm in the intervention group. The median postnatal follow-up duration was 24 months. Conclusion: This study highlights the importance of systematic evaluation and monitoring in managing ANH. While a significant proportion of cases resolve spontaneously, a careful assessment of associated anomalies and renal function is crucial in identifying cases requiring intervention. The arbitrary APRPD values presented underscore the potential for establishing diagnostic thresholds to guide clinical decision-making. Refinement of treatment protocols based on such parameters can improve outcomes and reduce unnecessary interventions in infants with ANH.https://journals.lww.com/10.4103/jpbs.jpbs_412_24antenatal hydronephrosisinterventionpostnatal evaluationprenatal ultrasoundrenal functionspontaneous resolution |
| spellingShingle | Rana P. Singh Shyam S. Sahu Abhishek Kumar Singh Rajiv Ranjan New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study Journal of Pharmacy and Bioallied Sciences antenatal hydronephrosis intervention postnatal evaluation prenatal ultrasound renal function spontaneous resolution |
| title | New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study |
| title_full | New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study |
| title_fullStr | New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study |
| title_full_unstemmed | New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study |
| title_short | New Insights into the Diagnosis, Monitoring, and Management of Antenatal Hydronephrosis, Aiming to Refine Treatment Protocols: A Clinical Study |
| title_sort | new insights into the diagnosis monitoring and management of antenatal hydronephrosis aiming to refine treatment protocols a clinical study |
| topic | antenatal hydronephrosis intervention postnatal evaluation prenatal ultrasound renal function spontaneous resolution |
| url | https://journals.lww.com/10.4103/jpbs.jpbs_412_24 |
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