Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis
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Elham Kebriyaei
Abstract
Objectives
Renal anomalies are the most common fetal abnormalities that occur during prenatal development, and are typically detected by observing hydronephrosis on fetal ultrasound imaging. Follow-up with post-natal ultrasound is important to detect clinically-important obstruction, because many of the pre-natal abnormalities resolve spontaneously. This study aimed to evaluate the postnatal hydronephrosis follow-up rate, and reasons for non follow-up in affected neonates.
Methods
In this cross-sectional study all neonates born during a period of one year at Ayatollah Mousavi Hospital with hydronephrosis on fetal ultrasound imaging were recruited. All mothers were also given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least a postnatal ultrasound was recommended from the fourth day of their neonates’ birth until the end of the fourth week. The neonates were subsequently observed for one month to determine the postnatal ultrasound follow-up rate and to reflect on diagnostic test results, reasons for failure to follow-up, as well as causes of hydronephrosis.
Results
In this study, 71 cases (1.2%) out of 5,952 neonates had fetal hydronephrosis on prenatal ultrasound images. The postnatal ultrasound imaging showed kidney involvement in 18 neonates (25%), particularly in the left kidney (61.1%). Seven neonates had no follow-up at one month (10%). No significant relationship was found between lack of follow-up and the neonates’ place of residence (p=0.42), maternal education (p=0.90), number of siblings (p=0.33), or gender (p=0.64).
Conclusions
Postnatal ultrasound follow-up rate in these neonates with a history of fetal hydronephrosis was incomplete even though parents had been provided with education and advice at their birth time. Accordingly, it is recommended to perform postnatal ultrasound once neonates are discharged from hospitals.
Funding source: ZUMS
Acknowledgments
This article is part of a Pediatric Residency Thesis, which was financially supported by ZUMS, Zanjan, Iran. The authors hereby would like to extend their gratitude to the Vice Chancellor’s Office for Research at ZUMS, Zanjan, Iran.
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Research funding: The present study was funded by the Vice Chancellor’s Office for Research at ZUMS, Zanjan, Iran.
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Author contributions: All the authors were involved in the study conceptualization, methodology, as well as validation and interpretation of its results. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: In this study, all the individuals were recruited upon obtaining their personal consent and they could withdraw at any stage of the study. As well, the demographic characteristics information remained confidential and was only used for research purposes. The study protocol was approved by the regional and national research Ethics Committees of Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran (Reference no. IR.ZUMS.REC.1393.102).
References
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Articles in the same Issue
- Frontmatter
- Reviews
- An overview of mental health during the COVID-19 pandemic
- Potential mechanisms of action of convalescent plasma in COVID-19
- Mini Review
- Gap of knowledge in diagnosis of pyoderma gangrenosum in clinical specialties education
- Opinion Papers
- Learning clinical reasoning from the fictional detectives
- Integrating infection and sepsis management through holistic early warning systems and heuristic approaches: a concept proposal
- (F)utility of urine Bence Jones proteins for “routine” screening for plasma cell dyscrasia
- COVID-19 and the Le Chatelier’s principle
- Original Articles
- Are sniffer dogs a reliable approach for diagnosing SARS-CoV-2 infection?
- Using body temperature and variables commonly available in the EHR to predict acute infection: a proof-of-concept study showing improved pretest probability estimates for acute COVID-19 infection among discharged emergency department patients
- Identifying children at high risk for infection-related decompensation using a predictive emergency department-based electronic assessment tool
- Antecedent treat-and-release diagnoses prior to sepsis hospitalization among adult emergency department patients: a look-back analysis employing insurance claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology
- Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology in an integrated health system
- Real-world virtual patient simulation to improve diagnostic performance through deliberate practice: a prospective quasi-experimental study
- Overutilization and underutilization of autoantibody tests in patients with suspected autoimmune disorders
- Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis
- Clinical performance of amperometry compared with enzymatic ultra violet method for lactate quantification in cerebrospinal fluid
- Case Report – Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: the contribution of faulty data gathering and synthesis to diagnostic error
- Case Report
- The COVID trap: pediatric diagnostic errors in a pandemic world
- Letters to the Editor
- Atrial arrhythmia and its association with COVID-19 outcome: a pooled analysis
- Serious game training in medical education: potential to mitigate cognitive biases of healthcare professionals
- Revisiting handoffs: an opportunity to prevent error
