What to do if you have hydronephrosis in your fetus: causes, diagnosis and coping strategies
Prenatal Hydronephrosis is one of the common abnormalities in prenatal ultrasound examination. It refers to the expansion of the renal pelvis and calyces caused by obstruction of urine discharge in both fetal kidneys. With the popularization of prenatal screening technology, this issue has gradually attracted attention. The following is a structured analysis and treatment suggestions for fetal hydronephrosis.
1. Common causes of fetal hydronephrosis
| Reason type | Specific instructions |
|---|---|
| Physiological hydrops | Temporary phenomena during fetal development, most of which will subside on their own |
| urinary system obstruction | Structural abnormalities such as ureteral stenosis and urethral valves |
| vesicoureteral reflux | Reverse flow of urine into the kidneys causing water accumulation |
| genetic or syndromic | Such as polycystic kidney disease, chromosomal abnormalities, etc. |
2. Diagnostic methods and grading standards
Fetal hydronephrosis is mainly diagnosed by ultrasound, and the following grading standards (SFU grade) are usually used:
| Grading | Ultrasound performance | Risk level |
|---|---|---|
| Level 1 | Dilation of renal pelvis only | low risk |
| Level 2 | Renal pelvis + partial calyceal dilation | medium risk |
| Level 3 | All calyces are dilated | high risk |
| Level 4 | Thinning of renal parenchyma | extremely high risk |
3. Clinical management strategies
1.Pregnancy management: Mild hydrops (grade 1-2) is recommended for regular ultrasound monitoring (every 4-6 weeks); severe hydrops (grade 3-4) requires combined fetal MRI evaluation, and intrauterine surgery should be considered if necessary.
2.post birth treatment: Newborns need to complete urinary system ultrasound examination within 48 hours. Choose the following options according to the situation:
| Check results | Processing method |
|---|---|
| Standing water disappears | Routine follow-up |
| Persistent mild accumulation of water | Review every 3-6 months |
| Severe hydrops with abnormal renal function | Surgical intervention (such as ureteral reimplantation) |
4. Prognosis and home care suggestions
1. About 80% of mild cases recover spontaneously within 1 year after birth and do not require special treatment.
2. Among children who require surgery, 90% can restore kidney function through minimally invasive surgery.
3. Key points of home care:
5. Latest research progress (hot spots in the past 10 days)
1.Artificial Intelligence Assisted Diagnosis: In 2023, a sub-journal of "Nature" reported that an AI algorithm can predict the risk of hydrops progression through ultrasound images, with an accuracy of 92%.
2.Fetoscopy surgery technique: Johns Hopkins Hospital in the United States successfully completed the world's first 22-week fetal cystoscopic surgery, and the renal function returned to normal after the operation.
3.gene therapy research: Mouse experiments show that CRISPR technology can repair the genetic defect that causes congenital hydronephrosis, and it is expected to enter clinical trials within 3 years.
Conclusion
Fetal hydronephrosis requires multidisciplinary collaboration (obstetrics, pediatric urology, genetics) to develop an individualized plan. The prognosis of most cases is good. Parents should maintain a scientific understanding, avoid excessive anxiety, and strictly follow the follow-up recommendations of professional doctors.
check the details
check the details
en
