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  1. #1
    Hollie1978's Avatar
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    Default mildly dilated fetal kidney??

    Hi again all! I have also been told at my 32 week scan that my baby has a 'mildly dilated left kidney - 7mm'. When I asked the ob about this he simply said it was a 'normal variation' (talk about a contradicting term!!) and that it would most likely just clear up. I've googled it and it seems that this condition has a lot of causes from a blockage in a kidney -urethra tube to a more serious kidney diseasee. Does anyone else have any experience in this sort of thing??

  2. #2
    Phantom's Avatar
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    Hi Hollie,

    My DD had a dilated left kidney that was picked up on my 20 week u/s. It was still there on my 34 week one. She had to have an u/s when she was three days old and then at 6 weeks she had a procedure that involved injecting dye into her ureter and using an x-ray to see if she had reflux (fortunately she didn't). She had to be on antibiotics for the first 6 weeks of her life. She then had to have follow up u/s at 3, 6, 9, 12, 18 months and a last one at 3 years which showed her kidney was normal .

    Try not to worry too much as most do tend to clear up.

    Bron
    Me (46) DH (46)

    My gorgeous Miss M 08.08.03 and My very cheeky Master R 12.05.05

  3. #3
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    Default

    Thanks, Bron - it is good to hear that your DD has normal kidneys now. Was the dye procedure very traumatic or was it okay? Do you know what the next step would have been had she had reflux?

    thanks again
    Hollie

  4. #4
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    I am an ex kidney reflux baby It started with recurrent ( and I'm talking back to back UTI's) when I was 18 months, so maybe its a bit different to your bub. Anyhow, I was put on a waiting list for corrective surgery as both my ureters (tubes from each kidney into the bladder) were attached to my bladder at the wrong angle. So when I finally got my op at age 10 (had to wait a LOOONG time on medicare as my parents didnt have the money to pay for it) they un-attached and re-attached the ureters. I was on antibiotics for that entire time, so my resistance to antibiotics is sky-high

    Sorry, I dont think that has anything to do with what you were talking about now I think about it. Hope someone can help you with some specifics
    I swam and I swam, and I damn well made it!

  5. #5
    Phantom's Avatar
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    Hi again Hollie,

    It was more traumatic for me than DD. I was ok at the start and the nurses commented how good I was and then I burst into tears . DD was as good as gold. She may have had a little cry, but it was probably more from being held down than the actual procedure. Sorry, I don't know what the next step would have been if she had reflux - maybe surgery like Erin needed??? I would think she would have had to stay on antibiotics to keep any UTI's at bay, but no idea what else would have happened.

    Bron
    Last edited by Phantom; 05-10-2006 at 04:48 PM.
    Me (46) DH (46)

    My gorgeous Miss M 08.08.03 and My very cheeky Master R 12.05.05

  6. #6
    Hollie1978's Avatar
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    Default

    Thanks Bron and Erin, hopefully my baby's dilated kidneys clear up and don't turn to reflux but its good to hear that even if she does have reflux then an op should clear it up.

    thanks again guys

  7. #7
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    Hollie

    I also had this problem picked up at my 19 week U/S (I am currently 22 weeks). We've talked it over with the sonographer and obstetrician and we've done quite a lot of research ourselves (DH is in the medical profession). We will have another scan at 28 and 32 weeks to see if it resolves by itself. If it doesn't then our baby will be scanned again at birth and if it is still enlarged our baby will have antibiotics. If it hasn't cleared up by itself then our babe will be looking at surgery at about 12 months. Apparently about 90% of cases clear up by themselves before birth, and of the 10% that don't only a very small % need to go on and have surgery. Our ob is getting us to go and see a paediatric renal specialist at 30 weeks just to talk it all over and relieve any anxiety we may have.

    Our sonographer actually said it is a good thing that it has shown up now and they can monitor it and use AB's if necessary. She said in the "oldendays" before U/S it went undetected and that is how people got irreversible kidney damage - in our cases this won't happen to our baby's as they are on to it! HTH

    Cheers

    Tania xxx

  8. #8
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    Default thanks, Tania

    Thanks for your reply, Tania - your info is much more informative than my ob's! I have also searched a lot on it and I am really hoping that it clears up before birth and at the very least does not require surgery!

    If you don't mind, when you go to the pediatric urologist, could you please tell me what he says? It may not apply to me and the baby but it is good to know what others say.

    Best of luck with your pregnancy and the baby

    Hollie

  9. #9
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    Hi Hollie,

    I thought I had wiped this, but just found it. You might have already read this info, but just in case:

    ANTENATAL HYDRONEPHROSIS

    What is antenatal hydronephrosis?

    Antenatal (before birth) hydronephrosis (fluid-filled enlargement of the kidney) can be detected in the fetus by ultrasound studies performed as early as the first trimester of pregnancy. In most instances this diagnosis will not change obstetric care, but will require careful follow-up and possible surgery during infancy and childhood.

    What causes antenatal hydronephrosis?

    Possible causes of antenatal hydronephrosis include:

    Blockage: this may occur at the kidney in the ureteropelvic junction (UPJ), at the bladder in the ureterovesical junction, or in the urethra (posterior urethral valve).
    Reflux: vesicoureteral reflux occurs when the valve between the bladder and the ureter does not fuction properly, permitting urine to flow back up to the kidney when the bladder fills or empties. Most children (75%) outgrow this during childhood but need daily antibiotic prophylaxis to try to prevent kidney damage before they outgrow the reflux.
    Duplications: perhaps 1% of all humans have two collecting tubes from a kidney. These may show up on fetal ultrasound. Occasionally patients with duplication have a ureterocele, which is a balloon-like obstruction at the end of one of the duplex tubes.
    Multicystic kidney: this is a nonfunctional cystic kidney.
    No significant abnormality: many of these dilated kidneys prove to be normal after delivery.




    UPJ obstruction: blockage at the left ureteropelvic junction (where ureter joins to the kidney) Posterior urethral valves: blockage at the outlet of the bladder Vesicoureteral reflux on the left: flow of urine back up ureter causing dilated ureter and kidney



    Multicystic kidney on the left: kidney may be large, leading to detection on ultrasound Duplication of ureters on both sides with ureterocele (seen where ureter joins bladder) on left causing bolckage

    How is antenatal hydronephrosis managed?

    Most cases of hydronephrosis diagnosed during pregnancy are just followed with ultrasound, monitoring the growth of the fetus and the condition of the kidneys. In these cases, a routine, normal delivery can be performed. Rarely, in a fetus with severe obstruction of both kidneys and insufficient amniotic fluid, drainage of the kidneys or bladder by tube or operation may need to be done. In these babies, however, the kidneys are often very abnormal and do not function properly regardless of treatment.

    What is done to evaluate the hydronephrosis after the baby is born?

    Several studies may need to be performed to evaluate the kidneys:

    ultrasound (done during the newborn period)
    voiding cystourethrogram (to exclude vesicoureteral reflux, a cause of 25-30% of antenatal hydronephrosis
    diuretic renal scan (to evaluate kidney function)
    What can be done to treat the hydronephrosis?

    The treatment of antenatal hydronephrosis depends on the underlying cause. Infants and children with who have vesicoureteral reflux are managed with antibiotics and surveillance with periodic ultrasounds and voiding cystograms. Infants and children with an obstruction or blockage of the urinary tract may require surgical correction. Babies with hydronephrosis without reflux or obstruction are followed with periodic ultrasounds to monitor the hydronephrosis and the growth of the kidneys. The management of multicystic dysplastic kidneys is controversial: the multicystic dysplastic kidney doesn't work, but the opposite kidney is usually normal. Some urologists recommend removal, whereas others do not remove the dysplastic kidney unless its large size causes problems or unless there is a question of tumor or blockage.

    HTH,
    Bron
    Me (46) DH (46)

    My gorgeous Miss M 08.08.03 and My very cheeky Master R 12.05.05

  10. #10
    Hollie1978's Avatar
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    Default Thanks, Bron

    Will be taking that to my next u/s!

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