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What Does The Following Anomaly Scan Report Indicate?
Question: Hi ,
I writing behalf of my sister to clarify few things since she is in different city. My sister is 21 weeks pregnant and she went to Anomaly scan last week and doctor reported that "Fetal Left Kidney not Imaged in Left Renal Fosa/Left ILLIAC Fosa" . Doctor said left kidney is not visible however partially filled bladder was noticed. also liquor was adequate. What are the chances of finding another kidney in further scans.
Also we would like to check for down syndrome risk and other trisomy risks at this stage. FYI NT was measured as 1.9 mm during 13 week, but no risk assessment was done. what are the tests at 21 weeks that can rule out other abnormalities.
attaching reports
I writing behalf of my sister to clarify few things since she is in different city. My sister is 21 weeks pregnant and she went to Anomaly scan last week and doctor reported that "Fetal Left Kidney not Imaged in Left Renal Fosa/Left ILLIAC Fosa" . Doctor said left kidney is not visible however partially filled bladder was noticed. also liquor was adequate. What are the chances of finding another kidney in further scans.
Also we would like to check for down syndrome risk and other trisomy risks at this stage. FYI NT was measured as 1.9 mm during 13 week, but no risk assessment was done. what are the tests at 21 weeks that can rule out other abnormalities.
attaching reports
Brief Answer:
Explained in detail.
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
As such, after 13 weeks of pregnancy, both kidneys can be seen in the baby by a good sonologist.
At 21 weeks, if one kidney is absent, and the scan is done at a reputed centre, the chances of finding another kidney in further scans are pretty low.
Now, babies with one absent kidney generally have no complications as long as the scan does not reveal other abnormalities.
You have not mentioned an important point, that is the presence of - single umbilical artery.
NOrmally there are two umbilical arteries in the fetus, a single one is also an aberration.
So that makes two aberrations in the ultrasound scan.
MOst cases of single umbilical artery are isolated, however the incidence of congenital abnormalities seen in babies with single umbilical artery is as high as 20 %.
Presence of other abnormalities seen together on scan ( such as one kidney absent ) raises the risk of having such abnormalities.
THat said, these are all percentages, even a 20 % risk of having congenital abnormalities means that there are more than 80 % chances that the baby is normal.
Many people have a single kidney, and they continue to lead normal lives and grow normally, as long as due precautions are taken after birth to avoid infection / damage to the other normal kidney.
Regarding screening for syndromes, 21 weeks is slightly too late for this.
The ideal time is before 13 weeks of pregnancy.
Furthermore, the screening blood test at 12 - 14 weeks was not done.
At 21 weeks, your options are limited.
You can go for second trimester Blood screening test now, its upper limit is 20 weeks, but it can still be done.
IF positive, amniocentesis can be done ( obtaining cells of fetus by needle biopsy ) to test for syndromes.
Generally this carries a miscarriage rate of 1 in 300 patients, and is not recommended above 20 weeks, but again you have no option.
You can go for non invasive maternal blood sampling to look for fetal cells, that can pick up abnormal syndromes too.
The best tool at this gestational age is to have a detailed level 2 genetic ultrasound scan done by a reputed sonologist, that will pick up most abnormalities.
All the best
Please feel free to discuss further.
Explained in detail.
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
As such, after 13 weeks of pregnancy, both kidneys can be seen in the baby by a good sonologist.
At 21 weeks, if one kidney is absent, and the scan is done at a reputed centre, the chances of finding another kidney in further scans are pretty low.
Now, babies with one absent kidney generally have no complications as long as the scan does not reveal other abnormalities.
You have not mentioned an important point, that is the presence of - single umbilical artery.
NOrmally there are two umbilical arteries in the fetus, a single one is also an aberration.
So that makes two aberrations in the ultrasound scan.
MOst cases of single umbilical artery are isolated, however the incidence of congenital abnormalities seen in babies with single umbilical artery is as high as 20 %.
Presence of other abnormalities seen together on scan ( such as one kidney absent ) raises the risk of having such abnormalities.
THat said, these are all percentages, even a 20 % risk of having congenital abnormalities means that there are more than 80 % chances that the baby is normal.
Many people have a single kidney, and they continue to lead normal lives and grow normally, as long as due precautions are taken after birth to avoid infection / damage to the other normal kidney.
Regarding screening for syndromes, 21 weeks is slightly too late for this.
The ideal time is before 13 weeks of pregnancy.
Furthermore, the screening blood test at 12 - 14 weeks was not done.
At 21 weeks, your options are limited.
You can go for second trimester Blood screening test now, its upper limit is 20 weeks, but it can still be done.
IF positive, amniocentesis can be done ( obtaining cells of fetus by needle biopsy ) to test for syndromes.
Generally this carries a miscarriage rate of 1 in 300 patients, and is not recommended above 20 weeks, but again you have no option.
You can go for non invasive maternal blood sampling to look for fetal cells, that can pick up abnormal syndromes too.
The best tool at this gestational age is to have a detailed level 2 genetic ultrasound scan done by a reputed sonologist, that will pick up most abnormalities.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your assessment . I dont know about the scan center , but my sister has scheduled an scan appointment for Monday and consulting the doctor this friday.we are going to another reputed scan center in XXXXXXX next visit. I am going with her. I have only heard about anomaly scan, do I need to ask doctor to write us 2nd level genetic scan. is it any different ? what is the blood test name for checking fetal cells?
on a seperate note, my wife is 15 weeks pregnant and we did go through all these risk assesement since our doctor suggested to do down/trisomy syndrome check with double marker blood test free beta hcg+ PAPPA. we dont have anyone born with genetic defects in our family.
my sisters doctor said everything is normal until this anomaly scan. what do you think about Nuchal thickness 1.9MM at 13 weeks , my sis age will be 27 during delivery.this is her first pregnancy/conception .can u assess the risk using this ? my scan center did this math. we have video of 3rd month scan , is this any useful for ruling out syndromes from a expert sonologist?
I have been reading about the relation between SUA and kidney problems. does single umbilical artery increases any other particular congenital problem? the sonologist said heart looks fine and no other abnormalities seen . what are the other things we should look at closely during this scan? how do we rule out any congenital issue.
At this moment, we want to ruleout all the other abnormalities and take precautions for the identified kidney absence
on a seperate note, my wife is 15 weeks pregnant and we did go through all these risk assesement since our doctor suggested to do down/trisomy syndrome check with double marker blood test free beta hcg+ PAPPA. we dont have anyone born with genetic defects in our family.
my sisters doctor said everything is normal until this anomaly scan. what do you think about Nuchal thickness 1.9MM at 13 weeks , my sis age will be 27 during delivery.this is her first pregnancy/conception .can u assess the risk using this ? my scan center did this math. we have video of 3rd month scan , is this any useful for ruling out syndromes from a expert sonologist?
I have been reading about the relation between SUA and kidney problems. does single umbilical artery increases any other particular congenital problem? the sonologist said heart looks fine and no other abnormalities seen . what are the other things we should look at closely during this scan? how do we rule out any congenital issue.
At this moment, we want to ruleout all the other abnormalities and take precautions for the identified kidney absence
Brief Answer:
Further explained.
Detailed Answer:
Hello again.
To elaborate further ,
1. Anomaly scan is the same as level 2 scan or genetic scan, these are all synonyms.
2. The blood test for checking fetal cells is called NIPT - Non Invasive prenatal Testing.
3. The nuchal thickness is normal, and the risk is low based on the nuchal thickness.
4. The 3rd month scan can be reviewed by an expert sonologist to look for more clues, and a detailed anomaly scan can be repeated.
5. Single umbilical artery increases risk of spinal defects, heart defects, bone defects etc. The heart is normal, and if the detailed scan is normal, most defects are ruled out . Nobody can guarantee this 100 % till the baby is born however.
Take care.
Further explained.
Detailed Answer:
Hello again.
To elaborate further ,
1. Anomaly scan is the same as level 2 scan or genetic scan, these are all synonyms.
2. The blood test for checking fetal cells is called NIPT - Non Invasive prenatal Testing.
3. The nuchal thickness is normal, and the risk is low based on the nuchal thickness.
4. The 3rd month scan can be reviewed by an expert sonologist to look for more clues, and a detailed anomaly scan can be repeated.
5. Single umbilical artery increases risk of spinal defects, heart defects, bone defects etc. The heart is normal, and if the detailed scan is normal, most defects are ruled out . Nobody can guarantee this 100 % till the baby is born however.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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