HELP - PEEK ANYONE? Ultrasound Issues

[cantwait4baby]

I am currently 19 weeks pregnant and during my u/s yesterday they found that my baby "BOY" yes, I am having a boy has something called mild fetal renal dilation?  What is that?  My Quad Screening was normal and they said everything else with him is fine but that I had to go back to a Pernatologist for follow up for this?

Also, I have a low lying placenta?  Anyone else ever have this?  I am so scared now.

[AndiJ78]

Always had a low placenta that early, but within a short amount of time, it moved up. Mine were also anterior as well, made for fun times,lol.

I would hold off on looking around online too much regarding the renal dilation, I think it will freak you out too much right now.  I will say try to focus on the positive: First, they said "mild" so that is a good start. Second, sometimes these things correct themselves. Wait to speak with the perinatologist to get a clearer picture.

When is the appointment?

[Cheyenne_08]

Herer is what I found on the subject!


Enlargement of the renal pelvis (the part of the kidney that collects urine) from 4 to 10 millimeters in diameter is called fetal pyelectasis or “renal pelvic dilatation”. Dilation of the renal pelvis to greater than 10 mm is called severe pyelectasis or hydronephrosis.

Dilatation of the urinary tract is detected before birth in 1 per 100 pregnancies, and is seen more commonly in male fetuses. However, only 1 in 500 cases results in significant disease

A fetus with severe pyelectasis or hydronephrosis is at increased risk of developing problems such as low amniotic fluid and kidney disease. In addition pyelectasis has a weak association with chromosome abnormalities, in particular Down syndrome.

What Causes It?

The most common causes of renal pelvis dilatation, which continues after birth is a blockage of the ureter (the tube that carries urine from the kidney to the bladder) where it joins the kidney  (ureteropelvic junction) and backward flow of urine from the bladder (vesicoureteric reflux) [6]. Less common causes of hydronephrosis include posterior urethral valves, urethral atresia, ectopic ureteroceles, duplication of the collecting system, megacystis-microcolon-intestinal-hypoperistalsis syndrome, prune belly syndrome, and cloacal malformation.

Does Pyelectasis Need Treatment?

Pylectasis involving only one kidney does not need intervention, but requires followed up ultrasound evaluation after 28 weeks for possible progression to pathological hydronephrosis. Severe hydronephrosis involving both kidneys is associated with increased risk of poor outcome, and is monitored for the development of low amniotic fluid.

An ultrasound is usually done 5 to 7 days after birth to reevaluate the infant’s kidneys. Most cases of mild pyelectasis where the renal pelvis measures less than 8 mm and involves only one kidney tend to resolve spontaneously either in utero or within a few months after delivery.  Pyelectasis greater than 8 mm is more likely to need surgical correction during childhood.

What is the Risk of Down Syndrome in a Fetus with Pyelectasis?

Presently genetic testing of the fetus (amniocentesis) is offered if the risk of Down syndrome in the fetus is 1 in 190 or greater. For a 34 year old woman the isolated finding of pyelectasis at midtrimester increases the risk of Down syndrome from 1 in 365 to 1 in 192.

For a woman 34 years of age or less with a normal triple marker screen for Down syndrome the risk benefit ratio does not favor amniocentesis when the only ultrasound finding is pyelectasis.

I hope this helps. I don't fully understand it, but hopefully it makes things a little clearer! I am so sorry you are going through this. I know what it is like to be told something is wrong, while not being sure what or how it will affect the baby!

[Cheyenne_08]

I wanted to add, that most the stuff I found had negative affects if the dialation was considered severe, and the fact that the dialation is mild, should make the outcome much better. I found many scientific journals on the subject, so if you are interested in reading studies and findings, those are available.

[cantwait4baby]

Thank you so much, I am waiting to hear back from the Pernatologist so my appt is not scheduled yet (they take 48 hours) ARGH!  My doctor did say that he has had many women with the mild renal issue come up and has NEVER delivered a baby with problems so he made me feel better.

Andi what is anterior?  I was not aware that the placenta could move up I thought it would only get worse so thank you so much for that information it makes me feel much better.  

Is there anything I should be doing to help the situation?  All the doctor said was to not overdue anything (lifting, intercourse, etc.)

[peekawho]

I'm going to say the same thing your OB did.  We see many ladies who have this (mild renal dilatation)  found on ultrasound, and its rarely a problem.  

At 19 weeks, the placenta is relatively very large in comparison to the size of the uterus.  As the uterus grows, the placenta appears to "move" (although it really doesn't, its just that the uterus gets much larger).  
Often at this gestation, you may have a diagnosis of a low lying placenta.  Later, it often is located much higher up and out of the way.

An anterior placenta is simply one that is in the front of the uterus.  Again, it doesn't mean much right now.

[AndiJ78]

No, the anterior thing just meant I wasn't supposed to feel the kicks from the outside that much...seems no one told the boys that ;-) It made it a little more difficult to use a Doppler and the ultrasounds, but was clinically insignificant for my pregnancies.

I, again, would suggest ignoring anything you read or are shown about this online right now. It tends to freak you out which certainly is not good while pregnant. The cortisol you are shooting throughout your body due to the stress of this "information" is more harmful than simply waiting a few day to talk with someone who is actually privy to your specific information.

Keep us posted and stop Googling ;-)

[cantwait4baby]

Thank you so much - I feel much better after reading your posts.  I am so excited about the boy that is helping overshadow my fears.  It is on my mind but not stressing me out (yet) I am going to wait for the more detailed U/S and the specialist to give me a reason to stress first.  My OB really was calming in his describing this to me and it is nice to hear other stories of success.  I just hope to God the baby is fine and I am not put on bedrest.  I have a 20 month old, bedrest - Oh My that would be interesting.

[GermanBaby]

This is my first baby at 36 years old. I am at 21 weeks and 4 days. My "second opinion" ultrasound discovered that my baby boy has 12mm and 13mm dilated kidneys. All previous testing and this ultrasound gave no "medical" reason for an amino. I have my next ultrasound on March 6 so I am praying that the amniotic fluid has not decreased and the dilation gets smaller. I will talk to a specialist then too. All one can do is wait and pray.

[anxiousmomtobe?]

So happy to hear you are having a wee man.  I hope the renal problem is so mild that it is a non issue.

[cantwait4baby]

I actually see a perinatologist now for his problem.  It is still there but mild - I have to go every four weeks up to 32 weeks and if it is still there at 32 weeks then I will have to see a urologist for him.  I am staying calm. I went through hell and back with my daughter after she was born so I have had some practice at having the you know what scared out of me.  Just trying to enjoy the fact I am going to have a son.  Which by the way - is so hard to adjust to when it comes to shopping.  I cant seem to find many boy things.

[cantwait4baby]

I know they are giving you a hard time because of your age - they told me that if I would have been 35 at delivery then they would have to increase my risks that go with this kidney problem and that I could have an amnio done but the fact that I am going to deliver just before 35 my risks stay lower.  My mother was with me for this appoitment and said to the specialist - women in their 40's have healthy babies everyday why do we need to scare them and the doctor said you are right - they do but they are obligated to give the risks.  Try to relax, I am sure you little peanut is fine and he will just have to have lots of u/s the next 20 weeks like my son.  

Good Luck.

[mami1323]

I don't think you should worry about it Kim.  But congrats on the boy.  I had an anterior placenta as well.  It took awhile for me to feel kicks in certain areas because the placenta acted like a cushion.  That doesn't last too long.  After awhile the baby is so big, you feel everything anyway.

[GermanBaby]

Thanks for your comments. I will be 37 when my Baby is born. Actually no doctor or specialist in either Canada or Germany has really "stressed the risks" of delivering after 35. I feel I am treated no differently than any other women that is having her first child. I had blood work and an u/s at the Fetal Maternal Clinic at 12 weeks in Calgary, Canada (both negative) and another two u/s at 20.5 weeks here in Germany. All doctors suggested that the diagnostic results indicate that an aminocentesis is not medically required, although "normal" anatomy and blood work are not the same as "genetically normal". The option was and is still there to have an amnio - I will wait till 25 weeks and see what changes have occured on that u/s.

I do find that one big difference between the USA Health system and the ones in Canada and Germany is that I feel the USA is very "risk adverse". That is, I feel that the medical profession does not take like to take "any" risks.  I lived and worked in the USA for 2 years, I am a public health epidemiologist.

However in all 3 countries I feel there are amazing medically trained specialists (many have trained in all 3 countries). The health systems are all very different but it is remarkable  that the outcomes are very "similar".

Right now I am trying "visualization techniques" to  "shrink" my babies kidneys :-) I will let you know in March how this turns out.

[peekawho]

Don't shrink your baby's kidneys to much!!

Seriously, good luck.  This type of mild fetal renal dilatation is not uncommon.  Hopefully, everything will be just fine.

Let us know how everything turns out.