Re: dilated fetal kidney's - Dr. Marchbein, more questions..

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I may be able to offer some advice based on what we have been told.

. I am wondering - if the amount of dilation is not medically > significant as to require correction/treatment, what effect could this
> dilation have on the baby's frequency and control of urination (could
> this possibly cause difficulty at a later age with learning to use the
> toilet or with bedwetting?)

I am told that in most cases the dilatation is gone by 6 weeks. If it persists beyond this point and all tests come back ok then it is presumed this is just how the kidneys will be. If this is the case then it causes no farther problems for the child. It has no effect on future urinary problems (as per my pediatric urologist).

, could it correct itself as the child grows

Yes, usually by 6-8 weeks. If the kidneys are still dilated at birth, as determined by a renal ultrasound then further testing should be done. My child had a voiding study 2 days after he was born. This was to determine whether he had urinary reflux (I believe that is what it is called). He did not have this but still had the dilatation. Because he was peeing ok, it was such an urgent situation.

> and at what point do the doctors determine that there actually is a
> dilation -- is this based on a statistical average of some sort much
> like a growth percentile or weight percentile?

I'm not sure at what measurement they determine dilatation. With our baby both renal pelvis portions of the kineys were dilated. I want to say it was 5mm on each side. As the baby grew so did the dilatation. We were told that if the dilatation got to 10mm on each side then we had to consider induction (as per maternal fetal specialist). however, the pediatric urologist felt that it is ok to have this much dilation as long as the shape of the kidney looked ok. Our baby's got to 10 and 13 mm and I was not induced until 37 weeks and that was because of my health not Cameron's.

How is the amount of > dilation measured, is this a measurement of the total size of the
> kidney, or how otherwise??

In my case they measured the whole kidney as well as the renal pelvis. It was the renal pelvis that was retaining the fluid. We will have another US at 6 weeks to determine if the dilatation is caused from a valve problem. If it is, then he will have surgery. I am told, though, that in most cases the fluid is gone by 6 weeks and there is nothing to worry about.

I hope I have helped some. Maybe Dr. Marchbein will have more to add.

Good Luck!

Cindy

>----- Original Message -----
From: Marshella <anonymous@obgyn.net> To: Multiple recipients of list PREGNANCY-BIRTH <pregnancy-birth@talk.obgyn.net> Sent: Sunday, November 14, 1999 9:00 AM Subject: Re: dilated fetal kidney's - Dr. Marchbein, more questions..

> At Fri, 12 Nov 1999, Harvey S. Marchbein, M.D. wrote:
>
> >>Could you please explain to me why this would be the case and what
action they would take if the problem still persists at 32 weeks. > >
> >It's frequently a boy-penis-urethra thing. Commonly called posterior
> >urethral valve syndrome (I'm presuming here with only your description
> >to go on). If it persists (and it will) nothing will be done unless
> >there is a large increase. Depending upon the increase, delivery may be
> >indicated in a very rare number of cases.
>
> >>If they take no action till the birth, what care will my child
> >>need?
> >
> >Sonogram and /or IVP (kidney Xray) while in the nursery.
>
> Hi Dr. Marchbein,
>
> My boy has also been scheduled for a follow up ultrasound due to this
> dilated kidney thing. I am presuming it was mild as the doctor didn't
> seem particularly concerned and there was no urgency in scheduling the
> follow up. I am wondering - if the amount of dilation is not medically
> significant as to require correction/treatment, what effect could this
> dilation have on the baby's frequency and control of urination (could
> this possibly cause difficulty at a later age with learning to use the
> toilet or with bedwetting?), could it correct itself as the child grows,
> and at what point do the doctors determine that there actually is a
> dilation -- is this based on a statistical average of some sort much
> like a growth percentile or weight percentile? How is the amount of
> dilation measured, is this a measurement of the total size of the
> kidney, or how otherwise??
>
> Thank you for your generous donation of your time to answer these and
> other questions on this board, I am very happy this resource exists!
>
> Marshella (and son due 2/10/00 after 5.5 yrs infertility)
>

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