ESPN 51th Annual Meeting

ESPN 2018


 
AN AUDIT OF THE TIMING OF POSTNATAL RENAL ULTRASOUNDS IN BABIES WITH ANTENATAL HYDRONEPHROSIS AT THE SOUTH WEST ACUTE HOSPITAL, ENNISKILLEN.
TAIWO LADAPO 1 RUKHSANA NAZLI 1 JAYASREE KUTTY 1 CLAIRE MATTIMOE 1

1- South West Acute, Hospital, Enniskillen
2- Western Health and Social Care Trust
 
Introduction:

There is likely inconsistency both within our Trust and across Northern Ireland in the scheduling of post-natal kidney ultrasounds for babies with antenatal hydronephrosis as there are no regional guidelines. The Society for Fetal Urology (SFU) guidelines has been modified for use by several UK Trusts. We aimed to retrospectively identify babies diagnosed with antenatal hydronephrosis and review the timing of their post-natal ultrasound scans alongside the Society for Fetal urology guidelines.

Material and methods:

Hospital records of all babies diagnosed with antenatal hydronephrosis from January 2015 to December 2016 were reviewed. Details of antenatal kidney ultrasound findings as well as the number and timing of their post-natal kidney ultrasounds were extracted. Antenatal hydronephrosis was classified as mild, moderate or severe based on the anterio-posterior diameter of the renal pelvis. Findings were reviewed alongside SFU recommendations. Data was analysed using Microsoft excel.

Results:

Twenty-six babies (M: F-0.6:10) were reviewed. Hydronephrosis was right-sided in 3(11.6%), left-sided in 8(30.8%), bilateral in 10(38.4%) and side was not stated in 5(19.2%). With regards to severity, 4(15.4%) were mild, 3(11.5%) were moderate, 7(26.9%) were mixed(bilateral) and this was not stated in 12(46.1%). Review of the timing of the 1st post-natal ultrasound revealed compliance with SFU guidelines as follows: mild (25%), moderate (0%), bilateral (42.8%). Sixteen (61.5%) had a second ultrasound with variation in their timing, 9(34.6%) had none and information was not available for 1. Twenty(76.9%) were followed up while 6(23.1%) had no further reviews.

Conclusions:

There was inadequate documentation of antenatal ultrasound findings which should guide post-natal management. All babies had a first post-natal ultrasound but not all received at least a second scan as recommended by the Society for Fetal Urology. We propose a Trust Guideline for the management of antenatal hydronephrosis in order to standardize practice.