What is neonatal hydronephrosis?

Neonatal (neo-NA-tal) hydronephrosis (hi-dro-ne-FRO-sis) is a condition affecting the

kidneys in newborns. This occurs when the baby's urine does not drain properly into
the bladder. When this happens, the urine gets trapped and overfills the kidneys.
The collecting part of the kidneys begins to stretch and enlarge (get bigger). This
then leads to pain, bleeding, or frequent infections, which may further damage your
baby's kidneys. Mild neonatal hydronephrosis may resolve before your baby reaches
the age of one year. Hydronephrosis has not been linked to anything parents may
have done during pregnancy, but it can be hereditary. Usually, these abnormalities
are seen during the mother's prenatal ultrasound evaluation. In some cases,
however, hydronephrosis may not be recognized until after birth or later in
childhood.

What causes neonatal hydronephrosis?

The following are possible causes of neonatal hydronephrosis:
Obstruction: A blockage of urine flow which can occur somewhere along the
urinary tract may cause hydronephrosis. The blockage is usually a narrowing or
kinking of the ureters- UPJ obstruction.
Reflux: This happens when urine travels back up to the kidney. This often occurs
when the muscles at the junction of the ureter and bladder do not work properly.
Others: These may include having fluid-filled cysts in the kidneys. Problems since
birth may cause neonatal hydronephrosis. These may include problems such as
having two ureters from one kidney or ureters draining outside the bladder.
What are the signs and symptoms of neonatal hydronephrosis?
Neonatal hydronephrosis does not usually cause any signs and symptoms. If
symptoms are present, your baby may have trouble passing urine. His urine may be
cloudy or pinkish to reddish in color. He may have a fever or abdominal (belly) pain.
How is neonatal hydronephrosis diagnosed?
Before your baby is born:

Fetal ultrasound: Caregivers may diagnose neonatal hydronephrosis while your

baby is inside your womb by doing a fetal ultrasound. This test uses sound waves to
show pictures of your baby that will show on a TV-like screen. Caregivers will learn
the size and shape of his kidneys, and look for a mass, stones, or cysts. They may
also know if there are other obstructions or problems with the amniotic fluid (fluid
around baby).
Urine tests: This test checks how well your baby's urinary tract is working.
Caregivers will take a urine sample from your baby's urinary bladder. The sample
will then be sent to the lab for tests.
After your baby is born:
Intravenous pyelogram: This is also called an IVP. An IVP is an x-ray of the
kidneys, bladder, and ureters. The IVP shows how well your baby's kidneys drain
urine. Dye is put into his vein (IV) which makes these organs show up better in x-ray
pictures. He may need to have more than one x-ray over short periods of time
during his IVP.
Kidney scan: During this test, pictures are taken of your baby's kidneys. Your baby
is given a small, safe amount of dye in an IV. Caregivers can look at the pictures to
know how well his kidneys are working. This may also tell the cause of any blockage
in his urinary tract and how bad it is.
Magnetic resonance imaging: This test is also called an MRI. An MRI uses
magnetic waves to take pictures of your child's abdomen. During an MRI, pictures
are taken of his urinary tract, muscles, or blood vessels. He will need to lie still
during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other
metal objects. This may cause serious injury.
Renal ultrasound: This is a test using sound waves to look at your baby's kidneys.
Pictures of his kidneys show up on a TV-like screen.
Voiding cystourethrogram: This test is also called a VCUG. It is a special x-ray
that checks your baby's urinary tract. A catheter (tube) is placed in the urethra. The
bladder is then filled with a liquid dye. X-ray images will be taken as the bladder fills
and empties. The images will show if there is any back flow of urine into the ureters
and kidneys and how well the bladder empties. It is also used to know if there is a
blockage in the urethra.
How is neonatal hydronephrosis treated?
After your child has underdone testing, a decision will be made about the method of
treatment:
Observational Therapy: Observational therapy involves close monitoring of your
child's health and kidney growth and function by your physician.

Surgical Therapy:
Much less common than observational therapy, surgical
therapy involves an operation to relieve the obstruction of the kidney, followed by
close monitoring of kidney development after the repair.

Sample 4 - Nurse Resignation Letter

This example is a simple nurse resignation letter that you can produce for any
hospital.

Today's Date

Hospital Name
Address
City, State, Zip Code

Dear Hospital Administrator,

Please accept this as my formal resignation letter from my position as nurse to be

effective from [date]. I have scheduled my resignation from your hospital a month
from now, which will allow me sufficient time to prepare my successor to take over
my position.
I wish to thank you and all my colleagues at [Hospital Name]l for all your help,
professional courtesy, and support. I have immensely enjoyed working here as the
head nurse for the past six years, and my experience with this hospital has been
greatly rewarding.
You probably
state. But I
perceived as
leadership of

already know the reason I am leaving is due to our moving to another

wanted to state officially that my resignation is in no way to be
my being unhappy or dissatisfied with the job, its responsibilities, or
[Hospital Name].

I wish you and the rest of the administrative team continued success, and I want to
take this opportunity again to thank you for permitting me to be part of the team.

Sincerely,
Your Name