Abstract
Widespread use of ultrasonography has resulted in an increase in the recognition of fetal hydronephrosis. The enthusiasm that accompanied early interventions has been tempered by the experience and results obtained over the past 2 decades. The goal has remained the same: to identify patients with serious prenatal obstruction and to identify those which may benefit from intervention. Myelomeningocele remains a devastating congenital anomaly. Fetal and experimental studies suggested that patients with myelomeningocele could benefit from prenatal intervention. Advances in technology and perinatal management have made intervention for more complex malformations such as myelomeningocele possible. This article will review current knowledge and will detail rational management for the management of prenatal hydronephrosis. The current state of antenatal myelomeningocele repair and the urologic implications will be described as well.
Highlights
During the past 2 decades pediatric urologists have begun acquiring patients with antenatally detected conditions
Fetal medicine has rapidly evolved since early experiences with the management of fetal hydronephrosis
Well-defined animal studies have yielded clues to the natural history and pathogenesis of obstructive uropathy and the efficacy of interventional techniques to ameliorate the sequelae of such obstruction
Summary
During the past 2 decades pediatric urologists have begun acquiring patients with antenatally detected conditions. With the widespread use of maternal ultrasound, fetal hydronephrosis has become increasingly detected, and it comprises the most common prenatally diagnosed malformation. The concept of the unborn child as a potential surgical patient has become firmly established [1]. Fetal medicine has rapidly evolved since early experiences with the management of fetal hydronephrosis. The natural history and pathophysiology of urinary tract obstruction has become better understood. Improvements in diagnostic imaging tools, advances in fetal urine sampling, enhanced interventional techniques and equipment, and a better understanding of the risks and outcomes in these babies have helped to develop rational intervention and observation strategies. The management of the fetus with hydronephrosis has remained controversial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
