Hydronephrosis transformation of kidneys during pregnancy - causes and treatment of pathology

Hydronephrosis transformation of the kidney during pregnancy in the fetus is characterized by a painful dilatation of the collective department in the kidneys, so urinary leakage is disturbed and hydrostatic pressure is increased.

Kidneys consist of calyx and pelvis, which constitute a collecting system where urine accumulation takes place. If the volume of accumulated fluid exceeds the norm, then the expansion of cups and pelvis develops.

Hydronephrosis transformation of the kidney in the fetus is considered the most frequent pathology, which is diagnosed by ultrasound examination. This disease can be caused by blockage of any level in the urinary canals, inadequate development of the walls of the urinary canals or muscles in the anterior part of the abdominal wall.

If the disease in the fetus is detected in the second trimester, then it is necessary to take into account the possibility of developing additional chromosomal pathologies.

If there is a blockage of the urinary canals, there is also a risk of developing dysplasia in the kidney. The earlier the blockage occurs and the more dense consistency it possesses, the greater the probability of dysplasia and the degree of its severity.

Complete blockage of the ureter at the time of ten weeks of pregnancy provokes multicystic renal dysplasia. With the development of blockage after ten weeks of pregnancy, or with partial blockage, the kidney is able to maintain normal forms to some extent, and ultrasound examination reveals thinning of its parenchyma, in which small sized cysts are located.

This is important!

Sometimes, in the formation of hydronephrosis, the enlarged renal pelvis and calyx are surrounded by a renal parenchyma with an abnormal structure. In other cases, the organ decreases in size in the absence or presence of a small volume of fluid in the pelvis.

At any degree of development of the pathology, the kidney function is markedly broken or they completely stop their work, and improvement is not observed even after removing the obstruction for urinary outflow.

How the pathology affects the side of the lesion

If the fetus has been diagnosed with hydronephrosis of the right kidney, the narrowing of the ureter could have formed at the level of the flow into the ureter of the right pelvis, on any segment of the right ureter or at the point of the ureter in the bladder. Occasionally an abnormal retraction of the ureter from the kidney or its compression by an additional vessel is detected.

Hydronephrosis of the left kidney is formed due to the same obstruction, but on the left side. Bilateral lesions of the kidneys of the fetus may indicate a deficiency of muscles in the abdominal region or an innate pathology of the bladder.

The development of hydronephrosis is especially dangerous in that as the enlargement increases, the compression of the renal parenchyma with urine can begin to be severe until its complete death. After that, hydronephrosis ceases to progress, but the kidney becomes atrophic. In this regard, the doctor often makes the decision to conduct an operative intervention: with a small lesion of the operation is carried out after the birth of the child, and if urgently needed - already during pregnancy on the kidney of the fetus. In the latter case, a temporary outflow of urine and plastics is required after the baby's birth.

Causes of development of hydronephrosis

Hydronephrosis transformation of the kidney in a newborn is considered a pathology of the structure of the organ or kidney vessels still in the process of intrauterine development due to the influence of the following factors:

• Incorrect ureteral localization.
• Constriction of ureteral lumen.
• The formation of an additional renal arterial vessel that presses on the ureter, creating an obstruction to the normal retention of urine.

Degrees of development of hydronephrosis and manifestation of the disease

Hydronephrosis transformation can be one-sided, when one of the kidneys is affected, or bilateral, when urinary leakage is disturbed on both sides. According to the degree of development, hydronephrosis is classified into:

1. Hydronephrosis transformation of the 1st degree in the newborn - enlargement of the pelvis takes place, but the integrity of the renal tissue is preserved and the kidney function remains normal.
2. Hydronephrosis transformation of the 2nd degree in the newborn - there is an increase in the size of the organ, the pelvis is enlarged considerably, the renal tissue is damaged and the functioning is deteriorating by approximately 40%.
3. Hydronephrosis transformation of the third degree in the newborn - the complete atrophy of the renal parenchyma develops, the affected kidney increases noticeably in size, its work worsens by almost 80% or the organ completely stops working.

The main symptoms of the disease in newborns are:

1. The presence in the urine of the blood.
2. Increased white blood cell count in urine.
3. Increased body temperature.
4. Pain during urination.

Treatment of pathology in newborns

Treatment of the disease depends on the degree of development of hydronephrosis. At the first degree of transformation, regular monitoring of the kidneys is required by ultrasound examination in a child's specialist.

With the second degree of kidney transformation treatment is correlated with the dynamics of the disease progression in the child - positive or negative dynamics. In case of deterioration of the condition of the organ and development of the third degree of transformation, operative intervention in the process of the disease is applied.

This is important!

In hydronephrosis of the kidney in a newborn, surgical intervention is performed by the endoscopic method - when there is no need for an open incision.

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