Abstract

 
 
 
 Introduction: Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract. In most cases, CAKUT are associated with infant mortality and morbidity in older children and adults. Hence this study was undertaken to follow up antenatally diagnosed cases of CAKUT and see their outcome in the first six months of life.
 Material and Methods: An observational follow up study was conducted in the department of Paediatrics in a tertiary care hospital. All inborn neonates, whose antenatal anomaly scans showed the presence of CAKUT were included in the study. Abdominal ultrasound (USG) were done on day three of life for all these neonates and those whose day three USGs showed presence of CAKUT were followed up over a period of six months and outcome was assessed.
 Results: CAKUT was more common among males. Hydronephrosis was the most common CAKUT in antenatal scans. Anomalies of the renal collecting system formed 93.9% of all CAKUT detected on antenatal anomaly scan and 57.4% of these resolved by six months of age. Abnormalities of the renal collecting system together formed 93.9% of all antenatally diagnosed CAKUT and were more common than abnormalities of the renal parenchyma which formed 6.1%. Postnatal resolution on day three USG was seen in seven out of 22 (31.8%) cases of antenatally diagnosed mild hydronephrosis irrespective of their site. Out of the 28 antenatally diagnosed hydronephrosis, 11 (39.3%) resolved at some point during the follow up period of six months.
 Conclusions: Antenatally diagnosed CAKUT were more common among male foetuses. On day three scan, 29.2% of CAKUT showed resolution. Hydronephrosis remained the most common antenatally as well as postnatally detected CAKUT. Anomalies of renal collecting system were better detected by antenatal scans than anomalies of renal parenchyma
 
 
 
Highlights
Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract
All neonates whose antenatal anomaly scans showed presence of CAKUT were included in the study
Trans-abdominal ultrasonography was done by a skilled staff member of the Department of Obstetrics and Gynaecology using a Philips EPIQ 5 USG machine with a linear probe of a frequency of 7-12MHz on day three of life for all neonates included in the study
Summary
Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract These anomalies are the most commonly diagnosed malformations in the antenatal period and constitute 15-20% of antenatally diagnosed congenital anomalies.[1] In most cases, CAKUT may remain asymptomatic, but many types of CAKUT are associated with infant mortality and cause significant morbidity in older children and adults.[2] Antenatal scans done between 16-20 weeks of gestation can pick up renal anomalies and in case of severe anomalies legal termination of pregnancy is possible at this fetal age.[35]. Our study is unique because the antenatal diagnosis of CAKUT was followed up meticulously till six months of age and their outcome was noted
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