Antenatally diagnosed urological abnormalities: where do we stand?

Abstract

During a \(5{\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}\)-year period 99 babies with antenatally diagnosed urinary tract abnormalities were referred for investigation, which revealed a total of 171 disorders. The antenatal findings were accurate in 65% of cases. Postnatal bilateral abnormalities were found in 55% of cases although bilaterality had only been noted antenatally in 31%. Referral was often delayed and in 14% the diagnosis of significant bilateral abnormality was not reached until after the 6th postnatal week. Four infants had normal postnatal ultrasound scans and yet were found later to have significant abnormalities. Another 4 had significant changes for the worse during follow-up. Inaccuracies in antenatal assessment suggest that great caution is required in counselling. Normal antenatal and postnatal sonography is not sufficient to exclude an abnormal urinary tract. The importance of early investigation and careful, continuous follow-up cannot be over-emphasised.