Outcome of Antenatal Renal Pelvic Dilatation – Review of Cases from a Tertiary Care Center, in the Armed Forces Hospital, Southern Region, Saudi Arabia

Abstract

Background: Renal pelvic dilatation (RPD) is the most common abnormality discovered on antenatal ultrasound. Unfortunately, little is known about antenatal hydronephrosis (ANH) and its associated etiology and outcomes. This study aimed to determine the incidence of antenatal RPD to evaluate antenatal resolution/progression and post-natal outcome. Also, this study aims to determine the outcome of patients diagnosed with ANH. Methodology: The current study followed a retrospective design. Data were collected from the medical records of infants born between 2019 and 2021, with dilated fetal renal pelvis in Armed Forces Hospital, Southern Region, Saudi Arabia. According to the radiological report on the follow-up, the patients were categorized based on their pelvic anteroposterior diameter (APD) detected on the second-trimester ultrasound into: APDs of 5-9.9 mm, 10-14.9 mm, and above 15 mm were classified as mild dilatation, moderate hydronephrosis, and severe hydronephrosis, respectively. Results: Among patients with RPD, 43.5% had mild dilatation while 33.3% had moderate hydronephrosis and 23.2% had severe hydronephrosis. There was no significant difference in incidence of RPD between mothers of different ages (P=0.302). Moreover, 69.6% of the patients were male with male: female ratio of 2.3:1. Among patients with RPD, 47 infants had good outcomes (68.1%), while 22 patients had poor outcomes. There was a significant difference in outcomes of patients with RPD according to their severity, where mild dilatation had the highest percentage of good outcomes as 86.7% of children with mild dilatation had good outcomes compared with 47.8% of infants with moderate hydronephrosis and 62.5% of those with severe hydronephrosis (P=0.009). Conclusion: Male infants have higher risk for developing RPD, although gender is not a predictor for severity or outcomes. Among patients with RPD, most patients have good outcomes. Key Words: Renal pelvic dilatation, antenatal hydronephrosis, infancy, ultrasonography, outcome, retrospective research design.