most common congenital renal abnormality

prone to UTIs after birth

in mild cases - 80% will be resolved by birth

Causes:

• posterior urethral valve
• Congenital PUJ obstruction - usually unilateral, not long term effects, presents post natally with loin pain (UTI/pyelonephritis/renal stones)
• Congenital VUJ obstruction - backflow of urine
• ureterocele - swelling of ureter as it enters bladder. can prevent flow of urine - can be associated with a duplex ureter (surgical Tx if its a problem)
• Congenital megaloureter
• Megacystis megaureter
• urine reflux: blockage - outflow obstruction or abnormal anatomy, neurological

10mm refer

Management

depends on degree of dilatation seen at 32 week scan

post natal assessment - ?passing urine

• abx prophylaxis given for renal pelvic dilatation >10mm or significant abnormalities - trimethroprim 2mg/kg is given
• urgent cases - inpatient USS post birth and U&E check - in children with significant anatomical abnormalities, bilateral pelvic dilataion >10mm or unilateral >15mm
  • Arrange MAG3 scan and Abx prophylaxis