Background/Objective: Fetal HYDRONEPHROSIS (HN)is the most common abnormality that is detected in the prenatal ultrasonography (US) and serial assessment of HYDRONEPHROSIS by US is often used in clinical decision making. The present study serves to determine quantitative index for follow up of the fetal HYDRONEPHROSIS versus the routine SFU grading system and AP diameter of pelvis study.Patients and Methods: This study was performed using GE LOGIQ 500 PRO series system 40. Hydronephrotic kidney in the prenatal US were included and in each fetus HYDRONEPHROSIS index (HI) was determined and 1, 6, 12 and 18-month follow-up after delivery. We selected a single sagittal view of the kidney. Perimeter of kidney and boundaries of hydronephrotic pericaliceal system within the kidney is outlined and software automatically calculated the area of kidney and dilated pelvis. HI is determined as follows: HI=total area of kidney-area of hydronephrotic sinus/total area x 100 and HI is recorded as dimentionless number.Result: In 25 cases (62.5%) HI showed decreasing hydronphrosis (higher HI) and in 12 cases (30%) HI showed increasing HYDRONEPHROSIS (lower HI) and in three cases (1.2%) HYDRONEPHROSIS was stable. Statistical analysis showed that HI was determined with an objectivity of 97 %. Conclusion: HI is a sensitive method for the assessment of HYDRONEPHROSIS overtime, quanitively. Especially, in severe hydronpehrosis that SFU grading system lacks clarity and depends on individual interpretation, the value of HI is greatest in this regard and indicates that HN is improving, deteriorating or stable. Because the extrarenal HN is less harmful, the HI is a better way to follow the HN than AP diameter of renal pelvis. It is a more sensitive indicator of the renal parenchymal status and allows better informed clinical decision making, identifying changes in HN not discerned by the current SFU system.

Widespread antenatal screening has resulted to increased detection of anomalies of the kidneys and urinary tract.Fetal HYDRONEPHROSIS (dilatation of the renal pelvis with or without dilation of the renal calyces) is a common finding on antenatal ultrasound examination occurring in 0.5 to 1 percent of pregnancies. Although renal pelvic dilatation is a transient, physiologic state in most cases, urinary tract obstruction and vesicoureteral reflux (VUR) can occasionally be causal. These conditions can prevent normal renal development and/or cause renal injury.Management approach of infants with prenatal HYDRONEPHROSIS is based upon confirmation of persistent postnatal HYDRONEPHROSIS and the predicative factors such as: the severity of the HYDRONEPHROSIS, whether it is bilateral or unilateral, presence or absence of ureteral dilation, the history of amount of prenatal amniotic fluid volume, the presence of other findings in the urinary system, and whether progression occurs. Emergent factors are thinning of the parenchyma and/or cortical cysts which indicate injury or impaired development of the renal cortex. An echogenic renal cortex may mean renal dysplasia.Abnormalities of the bladder such as increased thickness and trabeculation of the bladder wall are consistent with obstructive uropathy distal to the bladder (eg, PUV).Postnatal follow-up includes ultrasound examination of the kidneys and bladder in all affected infants. For unilateral HYDRONEPHROSIS without antenatal bladder pathology, it performs at one week after birth. In infants with bilateral HYDRONEPHROSIS and those with a severe hydronephrotic solitary kidney, it performs within 48 hours of birth. Voiding cystourethrogram (VCUG) performs in unilateral or bilateral persistent HYDRONEPHROSIS, antenatally detected HYDRONEPHROSIS which develops a urinary tract infection, hydroureteronephrosis, dilated, thick-walled bladder and dilated posterior urethra. Diuretic renography (DTPA) performs in moderate to severe unilateral or bilateral HYDRONEPHROSIS which do not show VUR.

Background: HYDRONEPHROSIS as a major health issue, has a significant contribution to the loss of kidney function and dialysis. Based on this the aim of this was to evaluate the probably etiology of HYDRONEPHROSIS in neonates. Methods: We have evaluated 314 neonates with fetal HYDRONEPHROSIS (by ultrasonography) as a study group. Cases were followed by voiding cystourethrogram 3 weeks after the start time. In addition, we took a Diethylenetriaminepentaacetic Acid scan at the end of 1st month of childbirth. At the end, we evaluated data based on the statistical analysis. Based on these examinations, etiology of HYDRONEPHROSIS were examined and recorded. Results: In total 314 infants with HYDRONEPHROSIS (55. 7% male and 44. 3% female) were included. Idiopathic cause (42%) as the most common etiology and vesicoureteric reflux as 2nd most common etiology of HYDRONEPHROSIS have been evaluated (37. 4%). Conclusions: Based on this finding, different causes can induce HYDRONEPHROSIS as a different etiology; therefore, we can control and reduce HYDRONEPHROSIS by checking vesicoureteric reflux as the most common possible etiology.

Background: The present study was conducted to compare the efficiency of HYDRONEPHROSIS index (HI) with those of pelvic anteroposterior (AP) diameter and parenchymal thickness in the diagnosis of fetal HYDRONEPHROSIS in the prenatal period, as well as 1, 6, and 12 months after birth. Methods: This study was conducted on pregnant women with the pregnancy age of > 30 weeks whose fetus was suspected of HYDRONEPHROSIS. The study participants were collected via the consecutive sampling method. The HI, pelvic AP diameter, and parenchymal thickness were measured at the baseline and 1, 6, and 12 months after delivery using ultrasound. According to the study design, the study participants were divided into three groups. Group A consisted of cases with decreased HI and higher HYDRONEPHROSIS severity. Group B was composed of subjects with relatively constant HI, and group C entailed individuals with increased HI and lower HYDRONEPHROSIS severity. All of the study measurements and analyses were performed on the three study groups. Results: The results revealed a negative association between HI and pelvic AP diameter but a positive association with parenchymal thickness. On the other hand, HI showed a significant correlation with parenchymal thickness in the diagnosis and prognostic assessment of fetal HYDRONEPHROSIS. Conclusion: The HI correlated with parenchymal thickness and pelvic AP diameter scores in all follow-up stages. Accordingly, HI can be concluded to be a good alternative to parenchymal thickness or pelvic AP diameter as a grading factor for HYDRONEPHROSIS. It is suggested to perform further studies to carefully assess the efficiency of HI in the diagnosis, prognosis, and clinical outcome of HYDRONEPHROSIS.