Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth

Background: Prenatal hydronephrosis (PNH) may be associated with congenital abnormalities in the urinary tract. This study aimed to determine and follow up on the fetus diagnosed with PNH until the first six months after birth.Methods: This prospective longitudinal study was conducted from May 2021...

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Main Authors: Zahra Akbarian-rad, Zahra Shafizadeh, Fatemeh Nasiri-Amiri, Sahar Sadr Moharerpour, Hossein Ali Nikbakht, Zeinab Pahlavan, Fatemeh Shafizadeh, Mohsen Haghshenas mojaveri, Mohammadreza Tabatabaie
Format: Article
Language:English
Published: Mashhad University of Medical Sciences 2025-01-01
Series:Iranian Journal of Neonatology
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Online Access:https://ijn.mums.ac.ir/article_24670_285897b46432da1d3c57dcdaca7a35a7.pdf
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author Zahra Akbarian-rad
Zahra Shafizadeh
Fatemeh Nasiri-Amiri
Sahar Sadr Moharerpour
Hossein Ali Nikbakht
Zeinab Pahlavan
Fatemeh Shafizadeh
Mohsen Haghshenas mojaveri
Mohammadreza Tabatabaie
author_facet Zahra Akbarian-rad
Zahra Shafizadeh
Fatemeh Nasiri-Amiri
Sahar Sadr Moharerpour
Hossein Ali Nikbakht
Zeinab Pahlavan
Fatemeh Shafizadeh
Mohsen Haghshenas mojaveri
Mohammadreza Tabatabaie
author_sort Zahra Akbarian-rad
collection DOAJ
description Background: Prenatal hydronephrosis (PNH) may be associated with congenital abnormalities in the urinary tract. This study aimed to determine and follow up on the fetus diagnosed with PNH until the first six months after birth.Methods: This prospective longitudinal study was conducted from May 2021 to July 2022 in fetuses who were diagnosed with PNH based on the size of the anterior-posterior diameter of the renal pelvis (APRPD) by a perinatologist with an S W 80 ultrasound machine. If it is ≥ 4 mm in the 2nd and ≥ 7 mm in the 3rd trimesters, it is considered PNH. These infants were followed up until the first six months after birth. Data analysis was performed using SPSS 20, Chi-square, Fisher's exact, and T-tests.Results: Of the 56 eligible fetuses, 50 fetuses were followed up. The mean gestational age at the time of diagnosis of PNH was 20.48 ± 5.37 weeks. Twenty cases of PNH (45.45%) spontaneously improved until birth. Thirty cases had hydronephrosis in the first week after birth, 16 of which (53.33%) were bilateral. The cause of PNH in 90% is idiopathic. Other causes include polycystic kidney, vesicoureteral reflux, and posterior urethral valve. One case died in the first week after birth. Forty-three cases had spontaneous recovery of PNH by six months, and 6 cases (12%) had adverse outcomes. The severity of PNH in the 3rd trimester had a significant relationship with adverse outcomes (P=0.001). The APRPD in the 3rd trimester has more sensitivity and specificity than in the 2nd trimester for predicting adverse outcomes after birth.Conclusion: In most cases, the cause of PNH is idiopathic, and the resolution of PNH occurs up to 6 months after birth. Moderate and severe PNH was associated with a poorer outcome and requires more follow-up and intervention.
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spelling doaj-art-8e655cecea9143c7a0dc55ac8e1b971e2025-08-20T03:09:35ZengMashhad University of Medical SciencesIranian Journal of Neonatology2251-75102322-21582025-01-01161333910.22038/ijn.2024.74690.244524670Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after BirthZahra Akbarian-rad0Zahra Shafizadeh1Fatemeh Nasiri-Amiri2Sahar Sadr Moharerpour3Hossein Ali Nikbakht4Zeinab Pahlavan5Fatemeh Shafizadeh6Mohsen Haghshenas mojaveri7Mohammadreza Tabatabaie8Department of Pediatrics, Clinical Research Development Unit of Rouhani Hospital, Amirkola Children's Non-Communicable Diseases Research Center, Babol University of Medical Sciences, Babol, IranStudent Research Committee, Babol University of Medical Sciences, Babol, IranDepartment of Midwifery and Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol, IranDepartment of Pediatrics, Amirkla Children's Non-Communicable Disease Research Center, Babol University of Medical Sciences, Babol, IranDepartment of Biostatistics & Epidemiology, Social Determinants of Health Research Center, Health Research Institute, Babol, IranDepartment of Gynecology and Obstetrics, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, IranResearch Development Unit of Ayatollah Rouhani Hospit Clinical Research Development Unit of Rouhani Hospital al, School of Medicine, Babol University of Medical Sciences, Babol, IranDepartment of Pediatrics, Clinical Research Development Unit of Rouhani Hospital, Amirkola Children's Non-Communicable Diseases Research Center, Babol University of Medical Sciences, Babol, IranDepartment of Radiology, Clinical Research Development Unit of Rouhani Hospital, School of Medicine, Babol University of Medical Sciences, Babol, IranBackground: Prenatal hydronephrosis (PNH) may be associated with congenital abnormalities in the urinary tract. This study aimed to determine and follow up on the fetus diagnosed with PNH until the first six months after birth.Methods: This prospective longitudinal study was conducted from May 2021 to July 2022 in fetuses who were diagnosed with PNH based on the size of the anterior-posterior diameter of the renal pelvis (APRPD) by a perinatologist with an S W 80 ultrasound machine. If it is ≥ 4 mm in the 2nd and ≥ 7 mm in the 3rd trimesters, it is considered PNH. These infants were followed up until the first six months after birth. Data analysis was performed using SPSS 20, Chi-square, Fisher's exact, and T-tests.Results: Of the 56 eligible fetuses, 50 fetuses were followed up. The mean gestational age at the time of diagnosis of PNH was 20.48 ± 5.37 weeks. Twenty cases of PNH (45.45%) spontaneously improved until birth. Thirty cases had hydronephrosis in the first week after birth, 16 of which (53.33%) were bilateral. The cause of PNH in 90% is idiopathic. Other causes include polycystic kidney, vesicoureteral reflux, and posterior urethral valve. One case died in the first week after birth. Forty-three cases had spontaneous recovery of PNH by six months, and 6 cases (12%) had adverse outcomes. The severity of PNH in the 3rd trimester had a significant relationship with adverse outcomes (P=0.001). The APRPD in the 3rd trimester has more sensitivity and specificity than in the 2nd trimester for predicting adverse outcomes after birth.Conclusion: In most cases, the cause of PNH is idiopathic, and the resolution of PNH occurs up to 6 months after birth. Moderate and severe PNH was associated with a poorer outcome and requires more follow-up and intervention.https://ijn.mums.ac.ir/article_24670_285897b46432da1d3c57dcdaca7a35a7.pdfcomplicationfetal hydronephrosisfetal pyelectasisperinatal outcome
spellingShingle Zahra Akbarian-rad
Zahra Shafizadeh
Fatemeh Nasiri-Amiri
Sahar Sadr Moharerpour
Hossein Ali Nikbakht
Zeinab Pahlavan
Fatemeh Shafizadeh
Mohsen Haghshenas mojaveri
Mohammadreza Tabatabaie
Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
Iranian Journal of Neonatology
complication
fetal hydronephrosis
fetal pyelectasis
perinatal outcome
title Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
title_full Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
title_fullStr Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
title_full_unstemmed Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
title_short Fetal Hydronephrosis in the Second and Third Trimester of Pregnancy and Six Months Follow-up after Birth
title_sort fetal hydronephrosis in the second and third trimester of pregnancy and six months follow up after birth
topic complication
fetal hydronephrosis
fetal pyelectasis
perinatal outcome
url https://ijn.mums.ac.ir/article_24670_285897b46432da1d3c57dcdaca7a35a7.pdf
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