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Urinary and Genital Disorders (Children)

17 week ultrasound

03/04/2011

Question:

I went to see a perinatologist today for my 17 week ultrasound (because I am 36 years old). He said there was a little urine in the baby`s kidney and this could be a few things. One of which could be Down`s. However,all the other markers for Down`s were normal. Do you have any other suggestions/thoughts on what this could be?

Answer:

Fluid in the kidney diagnosed on a prenatal ultrasound is called "hydronephrosis". This can be a normal variation in the development of the kidney or possibly be due to a partial blockage of the kidney. Hydronephrosis can range from a very mild problem that resolves itself spontaneously to a major obstruction that requires surgery in the first year of life.

A follow-up ultrasound later in the pregnancy can help distinguish between the two. If the kidney has severe hydronephrosis, a consultation with a pediatric urologist after birth would be necessary to decide if further evaluation and treatment is required. No prenatal intervention is ever performed on the baby if the other kidney is normal and the amniotic fluid levels are adequate. Your obstetrician will perform a follow-up prenatal ultrasound to keep an eye on the kidney during the pregnancy. It's also helpful to let the your pediatrician know about the issue after birth so that they can determine if subspecialty consultation is necessary.

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Response by:

William Robert DeFoor, MD, MPH William Robert DeFoor, MD, MPH
Associate Professor of Surgery
College of Medicine
University of Cincinnati