Indications for Investigation of the Urinary Tract in the Newborn

  • Harriet J. Corbett
  • Helen Fiona McAndrew


The urinary tract in the newborn may require investigation for a number of reasons. The urinary tract is the commonest system in which abnormalities are detected during antenatal ultrasonography (USS). The majority will have isolated hydronephrosis, with mild dilatation detected in as many as 1:100 pregnancies. Others will have more significant urological abnormalities thus investigation of the urinary tract is indicated to interpret the antenatal USS findings. Investigation is also indicated for those neonates presenting with urinary tract related symptoms. Equally, in neonates presenting with non-specific symptoms such as failure to thrive, poor feeding or prolonged jaundice, urinary tract pathology should be considered. Finally, there are neonates with congenital anomalies or syndromes with known associated uropathies who require further investigation. The range of such conditions or syndromes in which the urinary tract may be involved is extensive.


Antenatal diagnosis Urinary tract anomalies Imaging Management Outcomes 


  1. 1.
    Scott JE, Renwick M. Urological anomalies in the Northern Region Fetal Abnormality Survey. Arch Dis Child. 1993:68:22–6.CrossRefGoogle Scholar
  2. 2.
    Sairam S, Al-Habib A, Sasson S, Thilaganathan B. Natural history of fetal hydronephrosis diagnosed on mid-trimester ultrasound. Ultrasound Obstet Gynecol. 2001;17:191–6.CrossRefGoogle Scholar
  3. 3.
    NICE. Antenatal care: routine care for the healthy pregnant woman. National Institute for Clinical Excellence (NICE) Clinical guidelines. CG62: 2008. London: National Collaborating Centre for Women’s and Children’s Health.Google Scholar
  4. 4.
    Nguyen HT, Herndon CD, Cooper C, Gatti J, Kirsch A, Kokorowski P, Lee R, Perez-Brayfield M, Metcalfe P, Yerkes E, Cendron M, Campbell JB. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010;6:212–31.CrossRefGoogle Scholar
  5. 5.
    Fernbach SK, Maizels M, Conway JJ. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol. 1993;23:478–80.CrossRefGoogle Scholar
  6. 6.
    Keays MA, Guerra LA, Mihill J, Raju G, Al-Asheeri N, Geier P, Gaboury I, Matzinger M, Pike J, Leonard MP. Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis. J Urol. 2008;180:1680–2.CrossRefGoogle Scholar
  7. 7.
    Lee RS, Cendron M, Kinnamon DD, Nguyen HT. Antenatal hydronephrosis as a predictor of postnatal outcome: a meta-analysis. Pediatrics. 2006;118:586–93.CrossRefGoogle Scholar
  8. 8.
    Laing FC, Burke VD, Wing VW, Jeffrey RB Jr, Hashimoto B. Postpartum evaluation of fetal hydronephrosis: optimal timing for follow-up sonography. Radiology. 1984;152:423–4.CrossRefGoogle Scholar
  9. 9.
    Dejter SW Jr, Gibbons MD. The fate of infant kidneys with fetal hydronephrosis but initially normal postnatal sonography. J Urol. 1989;142:661–2.CrossRefGoogle Scholar
  10. 10.
    Wiener JS, O’Hara SM. Optimal timing of initial postnatal ultrasonography in newborns with prenatal hydronephrosis. J Urol. 2002;168:1826–9.CrossRefGoogle Scholar
  11. 11.
    Dhillon HK. Prenatally diagnosed hydronephrosis: the Great Ormond Street experience. Br J Urol. 1998;81(Suppl 2):39–44.CrossRefGoogle Scholar
  12. 12.
    : Dhillon HK. Prenatal diagnosis (Chap. 10). In: Thomas DFM, Duffy PG, Rickwood AMK, editors. Essentials of paediatric urology, 2nd edn. London: Informa; 2008. p. 133–42.CrossRefGoogle Scholar
  13. 13.
    Walsh TJ, Hsieh S, Grady R, Mueller BA. Antenatal hydronephrosis and the risk of pyelonephritis hospitalization during the first year of life. Urology. 2007;69:970–4.CrossRefGoogle Scholar
  14. 14.
    Coelho GM, Bouzada MC, Lemos GS, Pereira AK, Lima BP, Oliveira EA. Risk factors for urinary tract infection in children with prenatal renal pelvic dilatation. J Urol. 2008;179:284–9.CrossRefGoogle Scholar
  15. 15.
    Estrada CR, Peters CA, Retik AB, Nguyen HT. Vesicoureteral reflux and urinary tract infection in children with a history of prenatal hydronephrosis—should voiding cystourethrography be performed in cases of postnatally persistent grade II hydronephrosis? J Urol. 2009;181:801–6.CrossRefGoogle Scholar
  16. 16.
    American Academy of Pediatrics Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 1999;103:843–52.Google Scholar
  17. 17.
    Rudinsky SL, Carstairs KL, Reardon JM, Simon LV, Riffenburgh RH, Tanen DA. Serious bacterial infections in febrile infants in the post-pneumococcal conjugate vaccine era. Acad Emerg Med. 2009;16:585–90.CrossRefGoogle Scholar
  18. 18.
    Hsieh MH, Madden-Fuentes RJ, Roth DR. Urologic diagnoses among infants hospitalized for urinary tract infection. Urology. 2009;74:100–3.CrossRefGoogle Scholar
  19. 19.
    NICE. Urinary tract infection in children: Diagnosis, treatment and long-term management. National Institute for Clinical Excellence (NICE) Clinical guidelines. CG54:2007. London: National Collaborating Centre for Women’s and Children’s Health.Google Scholar
  20. 20.
    Crain EF, Gershel JC. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990;86:363–7.Google Scholar
  21. 21.
    Netto JM, Bastos AN, Figueiredo AA, Pérez LM. Spinal dysraphism: a neurosurgical review for the urologist. Rev Urol. 2009;11:71–81.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Kolon TF, Gray CL, Sutherland RW, Roth DR, Gonzales ET Jr. Upper urinary tract manifestations of the VACTERL Association. J Urol. 2000;163:1949–51.CrossRefGoogle Scholar
  23. 23.
    Goossens WJ, de Blaauw I, Wijnen MH, de Gier RP, Kortmann B, Feitz WF. Urological anomalies in anorectal malformations in The Netherlands: effects of screening all patients on long-term outcome. Pediatr Surg Int. 2011;27:1091–7.CrossRefGoogle Scholar
  24. 24.
    Azzoni R, Gerevini S, Cabitza P. Spinal cord sonography in newborns: anatomy and diseases. J Pediatr Orthop B. 2005;14:185–8.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Regional Department of Paediatric UrologyAlder Hey Children’s Hospital NHS Foundation TrustLiverpoolUK

Personalised recommendations