According to statistics, pyeloectasia in the fetus is not very common - in about 2% of cases, during an ultrasound examination of the fetus, doctors observe a similar pathology. Naturally, future mothers ask questions about what constitutes a disease, why it is dangerous, and what treatment methods modern medicine offers.
Kidney pyelectasis in the fetus - what is it?
What kind of ailment is this? Unfortunately, similar pathologies of the fetus are found in modern obstetric and pediatric practice, albeit not very often. Pieloectasia is a condition that is accompanied by excessive expansion of the renal pelvis, which is most often associated with difficulty in the normal outflow of urine.
In most cases , a child’s disease is detected during intrauterine development using ultrasound examination methods. Pyelectasis is often diagnosed on the left side of the fetus, as well as damage to the right kidney or bilateral expansion of the pelvis. According to statistical studies, boys suffer from this disorder 2-3 times more often than girls. In fact, a disease if untreated can lead to dangerous complications.
The main causes of the development of pathology
Modern medicine knows many reasons that can lead to pathological expansion of the pelvis and impaired urine outflow. First of all, it is worth noting that there is a certain genetic predisposition. In addition, the fetus may develop pathology if the mother suffered from pyeloectasia during pregnancy. On the other hand, acute inflammatory diseases of the urinary system suffered by a woman during gestation can be attributed to risk factors. Moreover, the probability of impaired normal development of the kidneys in a child increases with a severe pregnancy, for example, in the presence of preeclampsia, eclampsia, etc.
In some cases, various anomalies of development lead to pyeloectasia. For example, in some children, a valve forms in the area of the transition between the pelvis and ureter. Sometimes the ureter can be transmitted by large blood vessels or other neighboring organs. Risk factors also include uneven growth and organ formation during fetal development. In some children, the expansion of the pelvis is the result of muscle weakness, which is often observed with prematurity.
How is the presence of the disease determined?
Most often, fetal pyeloectasia is diagnosed in the fetus in the second half of pregnancy (during a routine ultrasound examination). Naturally, it is impossible to make an accurate diagnosis based on a test alone, because the child’s body is constantly growing, developing and changing. Nevertheless, it is believed that before the 32nd week of pregnancy, the size of the renal pelvis is 4 mm, and after - up to 7-8 mm. If during an ultrasound examination it is established that the size of the pelvis exceeds 10 mm, it is appropriate to talk about the presence of the disease.
In the future, additional tests are conducted that allow to identify the cause of the development of pathology. The main physical signs of pyeloectasia appear after the birth of the baby. In any case, a sick baby is prescribed studies such as intravenous urography, cystography, a radioisotope study of the kidneys, etc.
Diseases that are accompanied by pyeloectasia
Most often, pyeloectasia in the fetus indicates the presence of certain diseases, which include:
- Hydronephrosis is a disease caused by the presence of obstruction at the junction between the pelvis and ureter. In this case, the pelvis dilates, but the condition of the ureter is normal.
- Megaureter is another disease that occurs along with pyeloectasia. In this case, patients have vesicoureteral reflux. The ureter narrows strongly in the lower section, and a sharp increase in pressure is observed in the bladder.
- Bladder-ureteral reflux is accompanied by reverse urine reflux into the kidney, against which a significant expansion of the renal pelvis is observed.
- Ectopia is another disease in which the ureter does not flow into the bladder, but into the vagina (in girls) or the urethra (in boys). Most often, this pathology is observed with a doubling of the kidney.
- Pyeloectasia in the fetus may be associated with ureterocele. With such a pathology, the ureter at the site of inflow into the bubble is greatly inflated, but the outlet is very narrow.
The main complications of the disease
Of course, such fetal pathologies are not very common. And many people are wondering how dangerous pathology can be. In fact, the threat in this case is not the expansion of the renal pelvis, but the causes that lead to pathology.
If the normal outflow of urine from the kidney is difficult, this affects the functioning of the urinary system. In particular, with a similar pathology, compression of the kidney tissue is observed. In the absence of treatment, the structures of the organ begin to atrophy slowly. Reduced renal function is dangerous for the whole organism and often ends in complete loss of renal structures, which, of course, is dangerous. In addition, against the background of stagnation of urine, various inflammatory diseases, including pyelonephritis, can develop. In any case, if there is a suspicion of pyeloectasia, it is worthwhile to undergo a full examination and find the reason for the appearance of such a violation.
How is pyeloectasia treated?
In fact, doctors cannot determine whether the disease will progress after the birth of the baby. For example, bilateral pyeloectasia in the fetus is considered a physiological condition, which is caused by excess fluid in the body of the mother and child.
That is why in the first weeks or months of life, the child regularly undergoes various examinations so that doctors can detect whether the disease is progressing. Quite often, mild, moderate pyeloectasia goes away on its own with age. If no improvement is observed, the doctor may prescribe a conservative treatment.
Therapy in this case depends on the cause of the development of the pathology. For example, if the expansion of the pelvis occurred against the background of urolithiasis, then the patient is prescribed special drugs that help dissolve solid formations and quickly remove sand from the urinary system.
When is surgery necessary?
Unfortunately, conservative methods can eliminate the disease far from always. The question of surgical intervention is decided by the attending physician during the observation process. For example, if a baby has progressive pyeloectasia, which is accompanied by a rapid expansion of the pelvis and a gradual loss of kidney function, then surgical intervention is necessary. According to statistics, in about 25–40% of cases, surgery is performed as early as childhood.
To date, there are many methods of treating such a disease. Most often, during the procedure, the doctor removes the obstruction that interferes with the normal outflow of urine. In most cases, the operation is performed using endoscopic devices that are inserted through the urethra. A cavity procedure is required only in extremely serious cases.
Predictions for the child
Unfortunately, it is almost impossible to prevent such a disease. The only thing that is worth recommending to pregnant women, especially if they have a similar disease in their history, is to carefully monitor their health condition, maintain water balance, and also treat all kidney diseases on time.
As for the prognosis for newborns, most often after a well-conducted surgical operation the disease goes away. However, there is no guarantee that kidney pyeloectasia will not return in childhood or adulthood. That is why such children should be regularly examined by a specialist - only this will make it possible to identify pathology at the initial stage.