Management of antenatal urinary tract dilation— a clinical practice point for neonatal care providers

Abstract Antenatal urinary tract dilation (UTD) is a common clinical scenario for paediatricians. Differing guidelines, practice variability, and inconsistent reporting of ultrasound findings make it challenging to identify infants requiring follow-up, time postnatal imaging, and determine the need for antibiotic prophylaxis. Both antenatal and postnatal ultrasounds should assess the anterior–posterior renal pelvic diameter (APD) and for the presence of any complex features. Indication for additional scans, prophylactic antibiotics, and subspecialty involvement are based on these findings. The evidence for use of prophylactic antibiotics is limited but may be considered in a shared decision-making model with the family for patients with complex features or increased APD measurement. This practice point integrates existing guidelines and best evidence to provide a clinical pathway for managing antenatal UTD.