SUN-461 EVALUATION OF POSTNATAL ULTRASOUND FOLLOW-UP RATE AND ITS RELATED FACTORS IN NEONATES WITH FETAL HYDRONEPHROSIS BORN IN MOUSAVI HOSPITAL OF ZANJAN DURING YEARS 1395-96

Abstract

The most common fetal abnormalities during pregnancy are renal anomalies. Initial screening is performed by observation of hydronephrosis in fetal ultrasound, which is a nonspecific finding. About half of fetal hydronephrosis resolves uncomplicated and spontaneous, but a significant percentage remain pathologic, many of which may also have different kidney disorders and therefore require immediate medical treatment. It is not possible to distinguish possible diagnosis except by timely post-natal ultrasound. Therefore, it seems necessary to conduct studies such as this study to evaluate the rate of postnatal hydronephrosis, lack of follow-up reasons and frequency of different causes of hydronephrosis in neonates with fetal hydronephrosis. In this longitudinal descriptive-analytic study, all neonates born in Ayatollah Mousavi Hospital in Zanjan during one year, who had reported hydronephrosis in their fetal ultrasound, were enrolled. Initial infant data were extracted through identical questionnaires and hospital medical records. All mothers were given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least one post-natal ultrasound was recommended from the fourth day of birth until the end of the fourth week. The infants were observed for one month to determine the rate of postnatal follow-up, causes of non-follow-up, various diagnostic tests, and the causes of hydronephrosis and residual hydronephrosis in the first month of life. Data were analyzed by SPSS software version 16 using t-test, chi-square and ANOVA at the significant level of 0.05. In this study, out of 5952 newborns born in this center, 71 cases (1.19%) had fetal hydronephrosis in prenatal ultrasound. In 83.1% of cases ultrasound was performed in the third trimester of pregnancy. The highest degree of hydronephrosis was mild (78.2%) and in most of them, involvement was unilateral. Postnatal sonography showed kidney involvement in 18 infants (25%). The most common involvement was in the left kidney (61.1%). Seven infants had no follow-up after one month of birth (9.86%). Failure to follow up was due to the recommendation of physicians in 5 cases and the relatives of patients in 2 cases. There was no significant relationship between non-follow up with location of residence, maternal literacy, number of siblings, and gender of neonate. Postnatal follow-up rate in neonates with a history of fetal hydronephrosis after one month of birth is incomplete despite education at birthtime. Postnatal ultrasound should be performed at the time the baby is discharged from the hospital.