Brief Answer:
Pathophysiology explained.

Detailed Answer:
Thanks for asking once again on HealthcareMagic.

I have reviewed the attached reports. Let me try to resolve your queries. Fullness of renal pelvis, technically referred to as fetal pyelectasis, can occur due to a number of causes. The most common and harmless cause is physiological i.e. in the course of the normal functioning of the body. If that is the case, there is no reasons to be concerned. Renal pelvis can also be associated with certain conditions like Down syndrome and hence such conditions need to be excluded. Since the 20 week ultrasound alleviates this possibility, you need not be concerned about Down syndrome as well. The next possibilities to consider are some sort of obstruction (like PUJ obstruction, VUJ obstruction or urethral obstruction as in case of posterior urethral valves) or reflux (vesicoureteric reflux). At this stage it would be too hard to say whether any of these are present. A follow up ultrasound is therefore needed. If the fullness increases in the follow up ultrasound, further work up would be needed to ascertain the cause. If the fullness resolves in the follow up ultrasound, the present concern would be entirely alleviated.

You can see a pediatric urologist or nephrologist but frankly speaking, it is too early to comment and you would need to wait for the follow up ultrasound.

Feel free to write back in case of further queries.

Regards

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Brief Answer:
Quad test is a better indicator

Detailed Answer:
Thanks for writing back.

I am glad that it helped. I did not want to go into the technicalities the last time as most people rather find such things confusing.

A quad test is definitely better marker for Down syndrome but more importantly what matters is the timing. The later you do the tests, more accurate the results are. But later the test, lesser is the scope of intervention.

Feel free to write back.

Regards

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