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OP-053 Audit of postnatal management of antenatally diagnosed renal collecting system dilatation or hydronephrosis
  1. Kainaat Amin,
  2. Amanda Rodriguez Diaz,
  3. Wasim Asif
  1. St Luke’s Hospital Kilkenny, Ireland


Aim To monitor compliance with standard guidelines for postnatal follow up of antenatally diagnosed renal pelvic dilatation/hydronephrosis in our hospital. Antenatal urinary tract dilatation is a common abnormality detected on prenatal ultrasound scan, in up to 5% cases. It ranges from transient and benign dilatation to significant congenital anomalies. The severity is determined by antero-posterior renal pelvic diameter and/or degree of calyceal dilatation. Neonatal ultrasound with in first week of life may not reflect true anatomy, unless indicated due to severity of dilatation.

Material and Method Neonates who had renal ultrasound to follow up antenatal renal pelvic dilatation in the year 2021 were audited for compliance with the RCH guidelines.

Royal Children’s Hospital Melbourne guidelines based on third trimester scan findings:

  • Bilateral dilatation >10 mm requires RUSS pre discharge.

  • Unilateral (severe) dilatation >15 mm or moderate-severe calyceal dilatation requires RUSS pre discharge.

  • Unilateral (moderate) dilatation 10.1–15 mm with or without calyceal dilatation requires USS at 1–4 weeks of age.

  • Bilateral or unilateral (mild) dilatation 7–10 mm or mild calyceal dilatation requires USS at 4 weeks of age.

Figure 1 shows the percentages of different types of severity in our study group.

Results 16 babies underwent Renal USS in the year 2021. only 1 out of 16 babies had renal ultrasound scans performed as suggested by the RCH guidelines, the other 15 were not as per guidelines. Results as per table 1.

  • 9 babies had normal postnatal renal ultrasound scans while 7 had abnormal scans.

  • 10 babies had antenatal renal pelvis measurements documented, 4 had antenatal dilatation recorded only without measurements, in 2 cases the dilatation was recorded verbally without written documentation.

Abstract OP-053 Figure 1

Graph comparing results.

Abstract OP-053 Table 1

Compliance and results

Conclusions We are not following the standard RCH guidelines. Notably our postnatal ultrasounds are being arranged earlier than recommended. We recommend the following: 1. Development of departmental guidelines in concord with the Radiology department and in compliance with the RCH guidelines. 2. Re-audit in 1 year’s time to monitor compliance and close the audit loop.

  • Hydronephrosis
  • Renal collecting system dilatation

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