Antenatal hydronephrosis (ANH) is a common abnormality seen on routine prenatal ultrasound. Although this condition is invariably transient and benign, it can result in a deterioration in renal function and other significant co-morbidities. Once detected, careful ultrasound monitoring of the ANH is recommended during pregnancy. Postnatal antibiotic prophylaxis should be commenced after birth whilst investigating in a stepwise fashion in order to elucidate the underlying cause of the hydronephrosis. The aim is to preserve renal function, prevent urinary tract infection, and protect the upper tracts.
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