Antenatal renal pelvic dilatation and foetal outcomes — Review of cases from a tertiary care center in Karachi, Pakistan

Objective: To determine the incidence of antenatal renal pelvic dilatation to evaluate antenatal resolution/ progression and post-natal outcome. Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all women found with renal pelvic dilatation in antenatal scans between January 2011 and December 2013. A cutoff of 5mm was used to diagnose renal pelvic dilatation. Renal pelvic dilatation was categorised into three groups: mild (5-6mm in second trimester and 5-9mm in third trimester), moderate (7-10mm in second trimester and 10-15 in third) and severe (more than 10mm in second trimester and more than 15mm in third trimester). Results: Of the 13,337 scans, renal pelvic dilatation was found in 111(0.8%) cases. The overall mean maternal age was 28.5 ± 4.2 years. Renal pelvic dilatation was unilateral in 52(46.8%) and bilateral in 59(53.2%) cases. Post-natal scan was done in 61(55%) cases at the discretion of the neonatologist. A pathological finding was diagnosed in postnatal scan in 19(17.7 %) cases. Pelvi-ureteric junction obstruction was found in 6(5.4%) neonates, all in the severe renal pelvic dilatation category. Conclusion: The incidence of renal pelvic dilatation was low and the outcomes were normal in majority of cases.