Abstract:
Background: Timely postnatal imaging and prophylactic antibiotics are essential in reducing renal injury and long-term morbidity of antenatally detected Urological abnormalities. This audit assessed compliance with three standards: i)Appropriate scan request timing; ii)Scan completion within recommended timeframes and iii)Antibiotic prophylaxis (where indicated) against Regional Guidelines of Alder Hey Hospital.
Methods: A retrospective audit was conducted of neonates undergoing Renal tract ultrasound within the first two months of life at Whiston Hospital over 27months (January 2024 to March 2026). Patients were identified through radiology records, with clinical data collected from Electronic records.
Results: 78 neonates with antenatally diagnosed urological anomalies underwent imaging. 77% of requests were made within the correct timeframe, whilst 16.7% had no timeframe specified and 6.4% contained incorrect requests. Amongst the urgent cases, 11/13 scans were completed within 72 hours and two were delayed until days 13 and 85 of life. Of 65 non-urgent cases, only 19% were completed within the recommended <14days. 20% had their scan by 28 days, 61% of scans were delayed beyond 28 days.
14patients (18%) met criteria for prophylactic antibiotics. 12 of them received appropriate antibiotics. Three patients with significant abnormalities had no documented prescription, while medication records were unavailable in two cases.
Conclusion: Compliance with Regional guidelines were sub-optimal across all domains. Urgent scans were generally completed promptly once identified. Non-urgent imaging delays and under-prescribing of prophylactic antibiotics were common. Dedicated radiology slots have been introduced alongside recommendations for mandatory protocol labelling and antenatal scan review at NIPE(Newborn and Infant Physical Exam) to address limitations and improve Service delivery. Re-audit with closure of audit loop is planned in near future.
