Fluid dilation in fetal kidneys- any experiences?

[Anonymous]

I am 33.5 weeks and at the 20 week ultrasound it was discovered that there was dilation in the kdineys. I have since had a scan at 26 weeks and at 33 weeks to check up on the dilation. The amount of fluid went down between 20 and 26 weeks. Between 26 weeks and now it hasn't increased but has marginally gone down. My OB wants to do another scan in 3 weeks to check again. He says there is nothing to be worried out about since the levels are below the 5mm mark (levels are 4.8mm and 4.1mm in each side) and he can't detect a blockage. I still can't help feel nervous especially since I never had anything that needed to be monitored when I was pregnant with my son. Does anyone have any experiences with this? Did the fluid resolve itself either shortly after or before birth? If it did not, what happened? I just wish I could relax about this and forget about since it doesn't seem like much can be done before the birth even if there is a problem. Thanks for any advice or comfort.

[Anonymous]

don't worry too much about it. These type of kidney problems used to go undiagnosed until the child had multiple kidney infections and kidney damage. Now these abnormalities are discovered in-utero and closely monitored. My son has this, and so far we haven't had any problems. Just a daily antibiotic is the treatment.

[Anonymous]

Hi--
I have a 12 week old that had the same diagnosis. At I think 4 or 6 weeks, we had to take him to Children's to get a bunch of tests done--I was sobbing while they gave him the catheter, he was chomping on his binky and could have cared less.

Anyway, he has to be on antibiotics for the first 18 months as they said he could be prone to kidney infections, but that's it (and it really isn't a big deal).

Lots of people I know have had the same diagnosis, and none have turned out serious. I just told myself the whole time during my pregnancy is that in the absolute worst case, it was something that was completely fixable.

[Anonymous]

This is the OP: Thanks for the two above responses. I am glad that both of you think it hasn't been that bad. About the antibiotics, has it increased your chances and the baby's chances of getting thrush? Have the antibiotics been hard on their tummies? Thanks!

[Anonymous]

My first son had fetal hydronephrosis, first diagnosed at 20 weeks and then followed throughout my pregnancy. Unlike your baby, however, my son's measurements continued to increase on one side, and after he was born, testing determined that he had an obstruction that required surgery to fix.

Please don't get too nervous -- your baby's measurements are actually within the normal range, so most likely as others have said, everything is fine. It is a a very common anomaly seen on prenatal US -- the most common, I believe, and in most cases it resolves itself. With my second son, the measurements fluctuated but were never nearly as high as my first son's; however, because of the family history, we had a US when he was 3 weeks old, and everything was fine.

Continue to have it monitored and know that in the worst case scenario it is an eminently fixable problem -- the best kind of problem to have! My son is almost 3 yo, and after the surgical fix at 4.5 mos, he has been completely healthy and normal -- in fact, I'd venture that he's healthier than the average kid since I don't think I've taken him for a single sick visit to the ped.

Good luck -- happy to answer further questions if you have them....

[Anonymous]

Thanks PP. These posts are making feel much better about the situation. A few more questions about care. When you had the diagnosis, did you see a maternal fetal medicine specialist or consult with a pediatric urologist before or after birth? After birth was it your regular ped who did the tests or a specialist? I am asking because we haved moved away from DC and live in a small town in upstate NY where access to specialists is limited and doctors are often hesitant to refer people. My OB hasn't mentioned anything about consulting with a specialist. I am going to also ask my son's pediatrician what she thinks. Thanks again!

[Anonymous]

Hi - another experience - this was also detected in DS at the 20 week US, and so we had additional USs every four weeks to monitor - numbers went up and down until 32 weeks when DS's size caught up with his kidneys - at which point both the OBs and the pedis were satisfied that nothing was wrong. DS is now 18 months and very healthy.

[Anonymous]

We had a similar experience to the above poster. Sonograms noted fluid in kidneys as early as the 13wk nuchal trans, I think. Again at 20 wks and at 26 wks. (We got the 26wk sono for a diff't reason, but they mentioned it.) But by the time we got a sono at around 36 weeks (for breech) the fluid was no longer an issue, they said the baby had basically outgrown the problem. So there wasn't even a need for any follow-up after birth, as far as I know. (FYI: The u/s tech who first noticed it said while it wasn't considered "normal" per se, it was definitely not uncommon, so not to worry.)

[Anonymous]

Anonymous wrote:Thanks PP. These posts are making feel much better about the situation. A few more questions about care. When you had the diagnosis, did you see a maternal fetal medicine specialist or consult with a pediatric urologist before or after birth? After birth was it your regular ped who did the tests or a specialist? I am asking because we haved moved away from DC and live in a small town in upstate NY where access to specialists is limited and doctors are often hesitant to refer people. My OB hasn't mentioned anything about consulting with a specialist. I am going to also ask my son's pediatrician what she thinks. Thanks again!

21:15 poster here. We had our USs done at Georgetown, and the head of high-risk OB came in to look at the dilation at our follow-up (24 week) sono, and in retrospect I realize that she was pretty alarmist -- gave us all the worst-case-scenarios and insisted that we had to get a fetal MRI and talk to a pediatric urologist as soon as possible. So we did, and the pediatric urologist looked at us like we had six heads; he thought we had self-referred, and when he found out that the Gtown OB had referred us, he wrote her a not-so-nice letter telling her that there was nothing to be done before birth and not to refer future patients in our situation.

All of this is to say that given your baby's measurements, I think you're fine to follow it with your OB and ped, but if the measurements suggest a problem later in your pregnancy, talk to your ped about getting a referral for a renal US after the baby is born; this is what we did with #2. If anything worrisome shows up there, you'll have no problem getting a referral to a pediatric urologist, although it sounds like in your area they may be few and far between -- there are only four in the DC area (or at least this was the case in 2005). But cross that bridge when you come to it -- it really sounds like everything's going to be fine.