Geeta R. Karambelkar1, Sudhir D. Malwade2, Sharad Agarkhedkar3, Anshuman Singh4, Shradha R. Salunkhe5, Namarata Saini6
Congenital anomaly of kidney and urinary tract (CAKUT) are among the most common anomalies diagnosed prenatally. Early diagnosis and timely intervention can preserve renal function and avoid morbidity.
AIMS AND OBJECTIVES
To screen, select at-risk newborns for congenital renal and urinary tract anomalies by postnatal ultrasound and to study the pattern of distribution, clinical presentation and its correlation with antenatal scan.
MATERIALS AND METHODS
It was a prospective study. Postnatal ultrasound of 40 subjects fulfilling the inclusion criteria was performed on 4th day of life. Postnatal ultrasound findings were compared with antenatal records and immediate postnatal clinical course was assessed.
Out of 40 high-risk selected screen patients, 14 subjects were identified to have CAKUT on postnatal USG on 4th day of life. Hydronephrosis was the most common congenital renal anomaly with statistically good correlation with antenatal and postnatal scan (P <0.0001). Mild hydronephrosis detected on antenatal scan (with anterior pelvic diameter 7-9 mm) showed resolution on postnatal ultrasound in 3 subjects. The congenital anomalies in 4 cases were missed on antenatal USG. The number of LBW babies in the screened population was 60% and 64% babies with CAKUT were LBW. Family predisposition was seen in 12.5% of CAKUT population.
Congenital renal and urinary tract anomalies can be easily identified on antenatal and post natal ultrasound. LBW babies with family history of CAKUT or high-risk factors warrant radiological screening and biochemical evaluation. Hydronephrosis is the most common finding consistent in both the scans and had a good resolution rate. Prenatal screening would help in early identification of CAKUT anomalies and possible early surgical or medical intervention to prevent or slow ESRD.