Abstract

Fetal upper urinary tract dilatation is a commonly encountered birth defect. Six renal units in 4 fetuses from 181 consecutive pregnant women were demonstrated to have dilated upper urinary tract by routine obstetric ultrasonography since December 1992 to July 1993. In the postnatal period these cases were managed conservatively and followed by renal echogram and Tc-99m diethylene triamine penta-acetic acid (DTPA) diuretic renal scan as needed. Four of these six units (66.7%) resolved spontaneously within 1 to 6 months. The other two lesions deteriorated within 6 months and surgical intervention was required. Diuretic renal scan is an optimal method to differentiate functionally significant obstruction from nonobstruction or physiologic variants. The potential of spontaneous resolution for nonobstructive lesion was appreciated. For all suspected cases, careful observation at 2 to 3-month intervals for a period of 6 months is recommended.

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