Hydronephrosis: prenatal and postnatal evaluation and management

Clin Perinatol. 2014 Sep;41(3):661-78. doi: 10.1016/j.clp.2014.05.013. Epub 2014 Jul 19.


Antenatal hydronephrosis (ANH) is one of the most frequently detected abnormalities found on routine prenatal ultrasounds, affecting 1% to 4.5% of all pregnancies. Despite its prevalence, there continues to be uncertainty regarding the clinical impact after birth. Prognosis depends on the severity of the dilation. Expectant prenatal management is the rule with fetal intervention rarely needed in a few select cases. Ureteropelvic junction obstruction and vesicoureteral reflux are the most common postnatal diagnoses. A renal and bladder ultrasound is essential in the follow-up of patients with ANH and helps dictate further investigation with voiding cystourethrography and/or diuretic renography.

Keywords: Antenatal diagnosis; Hydronephrosis; Obstructive uropathy; Radiology; Urinary tract infections; Vesicoureteral reflux.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Disease Management*
  • Female
  • Humans
  • Hydronephrosis* / diagnostic imaging
  • Hydronephrosis* / embryology
  • Hydronephrosis* / therapy
  • Infant, Newborn
  • Pregnancy
  • Ultrasonography, Prenatal / methods*