DOCNICU

When to Worry? APD ≥4 mm in 2nd trimester and ≥7 mm in 3rd trimester. ANH with oligohydramnios ANH with extra-renal anomalies and soft markers ANH with any calyceal dilatation, renal parenchymal changes, bladder wall abnormalities. When to do a post-natal scan? USG KUB after adequate hydration, 3-7 days. MCU after 4-6 weeks USG KUB and MCU within 48 hours, if lower urinary tract obstruction. When to treat? Severe hydronephrosis- APD > 10mm - peripheral calyceal dilatation, renal parenchymal changes, bladder wall abnormalities, ureter abnormalities. PUV or lower urinary tract obstruction - Surgical approach VUR - Antibiotic Prophylaxis Normal MCU - Diuretic venography (after 4-6 weeks) to differentiate obstructive and non-obstructive hydronephrosis and for assessment of renal function.