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Suggest Treatment For Unilateral Dilation Of Pelvis Of Kidney

Posted on Sat, 27 Aug 2016

Question: Hi Doctor,
My wife is 32 weeks pregnant now with baby girl.
During 20th week scan,it was found that, baby's left kidney dilated with 8.9 mm.Right kidney measures 2.6mm. Doctor said it is unilateral hydronephrosis and other than that baby is fine.
On our 32 weeks scan,it is found that baby's left kidney dilated with 25.4 mm.
Baby weights 1.90 kg .
AC:271 mm
Liquor: 84mm
My wife is under medication :Duphaston(from 21st week),asprin( from 28th week),vitamin,Calcium,DHA.
We are worried about the problem and we seek your suggestion and expert advise on possible treatments and Anything to be cautious about to baby's kidney function after born and overall future health of the baby .

Answered by Dr. Deepti Verma (19 minutes later)

Brief Answer:
Neonatal investigations are necessary

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
Unilateral dilatation of pelvis of kidney is mostdue to unilateral obstruction of the renal system.
If the obstruction is there, the pelvic dilatation increases with time.
The excessive pelvic dilatation can lead to impaired kidney function, however if the other kidney is healthy and normal, there is not much to worry.
The baby should be delivered at a tertiary care centre with pediatric nephrologist.
She should get a ultrasound of kidneys at birth, and get various specialised tests to assess the cause of dilatation of renal pelvis and get further management accordingly.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepti Verma (22 hours later)

Hi Dr XXXXXXX

Thanks for the answer.
Does the 25 cm left kidney dilation at 32 weeks poses high possibility of impaired left kidney function.I would like to know the chances for not impairing kidney function.
Also is it recommended to deliver baby earlier to prevent further worsening of the problem?If so at which week it is advisable to deliver a baby?

Any measure to be taken to reduce further kidney dilation for the rest of the pregnancy weeks till delivery.And also food item to consume and avoid.

Thanks,

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Renal function cannot be assessed antenatally

Detailed Answer:
Hi dear,
Assessment of unilateral kidney dysfunction cannot be done antenatally.
The severity can be assessed after delivery only.
However, the if the kidney has become compressed and thin, due to pelvic dilation, then the it is likely that the kidney' s function has decreased.
There is no use of early delivery, as the renal function has been decided by now.
There are no measures or food items which can decrease further dilation of pelvis.
I will suggest you to get her 2 weekly ultrasound and deliver the baby around 37-38 weeks of gestation at a tertiary care centre.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Vaishalee Punj