Prenatal Urinary Tract Dilatation

• Published in: Urologic clinics of North America Vol. 45; no. 4; pp. 641 - 657
• Main Authors: Balthazar, Andrea, MD, Herndon, C.D. Anthony, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2018
• Subjects: Female; Humans; Hydronephrosis; Hydronephrosis - diagnosis; Hydronephrosis - embryology; Kidney - diagnostic imaging; Kidney - embryology; Pregnancy; Prenatal diagnosis; Radiology; Ultrasonography, Prenatal; Urinary Bladder - diagnostic imaging; Urinary Bladder - embryology; Urinary Tract - diagnostic imaging; Urinary Tract - embryology; Urinary tract dilatation; Urinary tract infection; Urology; Vesicoureteral reflux; Radiology; Urinary tract dilatation; Urinary tract infection; Prenatal diagnosis; Vesicoureteral reflux; Hydronephrosis
• ISSN: 0094-0143; 1558-318X
• DOI: 10.1016/j.ucl.2018.06.011

Urinary tract dilatation (UTD) is the most common congenital anomaly detected on prenatal ultrasonography (US), affecting 1% to 3% of all pregnancies. This article focuses on the prenatal detection of UTD and the postnatal evaluation and management based on the UTD grading system risk assessment. Prophylactic antibiotics and postnatal imaging are discussed. The recent management trend is for a more conservative approach to minimize unnecessary testing and exposures to the fetus and neonate while detecting those who may have clinically significant disorder. The renal bladder US remains a critical part of the evaluation and helps guide further investigations.