Pyeloectasia in the fetus. Kidney pyeloectasia in the fetus: treatment and causes

According to statistical data, pyelonectasia in the fetus is not very common - in about 2% of cases during the ultrasound examination of the fetus, doctors observe a similar pathology. Naturally, future mothers ask questions about what a disease is, what it is dangerous, and what treatments modern medicine offers.

Kidney pyeloectasia in the fetus - what is it?

What kind of ailment is this? Unfortunately, similar fetal pathologies in modern obstetrical and pediatric practice are encountered, albeit not very often. Pyeloectasia is a condition that is accompanied by excessive expansion of renal pelvis, which is most often associated with a difficulty in the normal outflow of urine.

In most cases , the child's illness is detected even during intrauterine development using ultrasound examination methods. It is often diagnosed pyeloectasia to the left of the fetus, as well as damage to the right kidney or bilateral expansion of pelvis. According to statistical studies, boys suffer from this disorder 2-3 times more often than girls. In fact, a disease in the absence of treatment can lead to dangerous complications.

The main causes of the development of pathology

Modern medicine knows many reasons that can lead to abnormal enlargement of the pelvis and a violation of urinary outflow. First of all, it should be noted that there is a certain genetic predisposition. In addition, the fetus can develop pathology in the event that during pregnancy, the mother suffered from pyeloectasia. On the other hand, the risk factors include acute inflammatory diseases of the urinary system, transferred by the woman during the fetal gestation. Moreover, the probability of disrupting the normal development of kidneys in a child increases with severe pregnancy, for example, in the presence of preeclampsia, eclampsia, etc.

In some cases, various developmental anomalies lead to pyeloectasia. For example, some children form a valve in the area of the transition between the pelvic and ureter. Sometimes the ureter can be transmitted by large blood vessels or other neighboring organs. Risk factors are also referred to as uneven growth and organ formation during intrauterine development. In some children, the expansion of pelvis is a result of the weakness of the muscular apparatus, which is often observed with prematurity.

How is the presence of the disease determined?

Most often, the kidney pyeloectasia in the fetus is diagnosed in the second half of pregnancy (during a planned ultrasound study). Naturally, it is impossible to make an accurate diagnosis on the basis of a test alone, because the child's organism constantly grows, develops and changes. Nevertheless, it is considered 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 the 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 performed, which allow to identify the cause of the development of pathology. The main physical signs of pyelonectasia appear after the birth of the child. In any case, the patient is prescribed such studies as intravenous urography, cystography, radioisotope study of kidneys, etc.,

Diseases that are accompanied by pyeloectasia

Most often, pyelonectasia in the fetus indicates the presence of certain diseases, which include:

• Hydronephrosis is a disease caused by the presence of obstruction in the place of transition between pelvic and ureter. At the same time, the pelvis widens, but the condition of the ureter corresponds to the norm.
• Megaureter is another disease that occurs with pyeloectasia. In this case, patients have vesicoureteral reflux. The ureter strongly narrows in the lower part, and in the bladder there is a sharp increase in pressure.
• The bladder and ureter reflux is accompanied by a reverse urine throw into the kidney, against which there is a significant expansion of the renal pelvis.
• Ectopia is another disease in which the ureter does not enter the bladder, but into the vagina (in girls) or the urethra (in boys). Most often, this pathology is observed when the kidney is doubled.
• Pyeloectasia in the fetus may be associated with a ureterocele. With a similar pathology, the ureter at the point of confluence into the bladder is strongly inflated, but the outlet is very narrow.

The main complications of the disease

Of course, such pathologies of the fetus are not very common. And many people are wondering about 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, it affects the work of the urinary system. In particular, with such a pathology, compression of the kidney tissues is observed. In the absence of treatment, organ structures begin to slowly atrophy. Reducing the function of the kidneys is dangerous for the whole organism and often results in the complete destruction of the kidney structures, which, naturally, is dangerous. In addition, against the background of stagnation of the urine, various inflammatory diseases, including pyelonephritis, can develop. In any case, if there is a suspicion of pyeloectasia, it is worthwhile to undergo a complete examination and to find out the cause of such a violation.

How is pyeloectasia treated?

In fact, doctors can not determine whether the disease will progress after the birth of the child. For example, bilateral pyeloectasia in a fetus is considered a physiological state, which is caused by an excessive amount of 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 find out whether the disease progresses. Quite often, mild, moderate pyeloectasia passes by itself with age. If improvements are not observed, the doctor can prescribe conservative treatment.

Therapy in this case depends on the cause of the development of pathology. For example, if the expansion of the pelvis has occurred against the background of urolithiasis, the patient is prescribed special preparations that promote the dissolution of solid formations and the rapid excretion of sand from the urinary system.

When is surgery necessary?

Unfortunately, it is not always possible to eliminate the disease with conservative methods. The question of surgical intervention is decided by the attending physician in the course of observation. For example, if a baby has a progressive pyeloectasia that is accompanied by a rapid expansion of the pelvis and a gradual loss of kidney function, then surgery is necessary. According to statistics, approximately in 25-40% of cases the operation is carried out even in 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 carried out using endoscopic instruments, which are introduced through the urethra. Cavity procedure is required only in extremely serious cases.

Projections 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 their history is a similar disease - carefully monitor the health, observe the water balance, and also in time to treat all kidney diseases.

As for the prognosis for newborns, most often after a competently performed surgery, the disease goes away. However, there is no guarantee that kidney pyelonectasia will not return in childhood or adulthood. That is why such children should regularly undergo examination with a specialist - only this will make it possible to identify pathology at the initial stage.