Evaluating Neonates With Antenatal Hyderonephrosis Using a Standard Protocol: An Audit of Hospital Records

ABSTRACT

Aims: To audit the extent of evaluation of neonates with antenatal hydronephrosis. Methods:Records of all neonates with antenatal hydronephrosis between January 2013 andDecember 2016 were audited to look for patient factors and investigation results. Results:290 records were evaluated, 93 (32%) of which had abnormalities detected on voidingcystourethrogram. In the presence of hydroureter, 65% had an abnormality while in theabsence only 11% were abnormal. In the presence of pelvis ?20 mm, 93% had abnormaldiuretic renogram, while with pelvis <20 mm, only 1.5% were abnormal (P=0.001). Numbersneeded to harm calculation revealed 1 in 2 patients would receive an unnecessary voidingcystourethrogram in the absence of hydroureter, and unnecessary diuretic renogram whenpelvis <20 mm. Conclusions: While evaluating neonates with antenatal hydronephrosisinvasive tests can be limited, if evaluation is guided by ultrasonographic criteria.