According to statistical data, pyeloectasia infetus is not very common - in about 2% of cases during an ultrasound examination of the fetus, doctors observe a similar pathology. Naturally, future mothers ask questions about what constitutes a disease, how dangerous it is, 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, a child's illnessare detected during intrauterine development by 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 the 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,can lead to abnormal enlargement of the pelvis and impairment 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 a woman during gestation. Moreover, the probability of disrupting normal kidney development in a child increases with severe pregnancy, for example, in the presence of preeclampsia, eclampsia, etc.
In some cases, pyeloectasia isvarious developmental anomalies. For example, some children form a valve in the area of transition between the pelvis and ureters. 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 pyelonectasia of the kidneys in the fetusis 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.
Further tests are conducted,which allow us 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. In this case, pelvic dilates, but the status of the ureter corresponds to the norm.
- Megaureter is another disease that arisestogether 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 casting of urine 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 into 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 swollen, but the outlet is very narrow.
The main complications of the disease
Certainly, similar fetal pathologies occurnot very often. 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,this 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, the structure of the body begins to slowly atrophy. Decreased kidney function is dangerous for the whole organism and often ends with 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 you suspect a pyelonectasia, you should undergo a complete examination and find out the cause of such a violation.
How is pyeloectasia treated?
In fact, doctors can not determine whetherthe disease progresses 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 lifethe 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 causedevelopment 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, to eliminate the disease conservativemethods can not always be. 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 techniquestreatment of 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 performed using endoscopic instruments, which are inserted through the urethra. Cavity procedure is required only in extremely serious cases.
Projections for the child
Unfortunately, to prevent such a diseasealmost impossible. The only thing that is worth recommending to pregnant women, especially if there is a similar history in their history, is to closely monitor the health, observe the water balance, and also treat all kidney diseases on time.
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.