How to manage fetal right kidney hydronephrosis at 36 weeks

Management of fetal right kidney hydronephrosis at 36 weeks gestation requires comprehensive consideration: 1. Observation and monitoring: If the hydronephrosis is mild and isolated, temporary observation with regular follow-up monitoring may be appropriate. Some physiological hydronephrosis may resolve spontaneously as the fetus develops. 2. Etiological diagnosis: Perform detailed examinations such as color Doppler ultrasound and fetal three-dimensional ultrasound to determine the cause of the hydronephrosis. Common causes include urinary tract obstruction (e.g., ureteral stenosis, congenital ureteral valve), chromosomal abnormalities, and maternal factors. 3. Treatment: If the hydronephrosis is caused by maternal factors, diuretic medications such as furosemide tablets or hydrochlorothiazide tablets may be used under a physician's guidance; however, caution is required to avoid adverse effects on the fetus. If the hydronephrosis is severe (e.g., exceeds 15 mm or 2 cm) and the cause is clearly identified as urinary tract obstruction, cesarean delivery may be considered to terminate the pregnancy, followed by further treatment after birth.