Kidney pyeloectasia in the fetus: clinical manifestations and causes

  • Kidney pyeloectasia in the fetus: clinical manifestations and causes

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    Sometimes, during an ultrasound during pregnancy, the fetus may reveal an enlargement of the renal pelvis - pyeloectasia. This diagnosis is established in the second half of pregnancy, especially in male fetuses. The norm is the following size of renal pelvis: second trimester - no more than 5 mm.the third - 7 mm. When the pelvis extends more than 10 mm, there is a buildup of fluid in the kidneys, which is called hydronephrosis.

    What is the norm of kidney enlargement in the fetus?

    At the moment, specialists have not established clear criteria for the diagnosis of pyeloectasia. What minimal expansion of renal pelvis is normal?- this is the main issue when studying this disease. Many experts believe that the expansion of renal pelvis more than 4 mm to 32 weeks and more than 7 mm after 36 weeks is pyeloectasia. Twice as often, kidney pyelonectasia in the fetus is manifested in boys than in girls.

    When diagnosing "pyeloectasia", expectant mothers have many questions: what are the causes of this disease, what kind of threat does it bear and will continue to develop after the birth of the child? This article will provide answers to questions that may be associated with this disease.

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    This is important! Expansion of renal pelvis is pyeloectasia. It is acquired and congenital.

    There are some reasons why a left kidney pyeloectasia can develop in a fetus or a right kidney:

    • When a large amount of water is consumed, the human kidneys are simply unable to perform their functions on time;
    • The presence of adenoma, prostate, tumor or hormonal imbalance;
    • Narrowing of the urethra, stenosis or phimosis;
    • Blockage of the urinary tract, ureter, the presence of bacteria and infections( this cause is more common in adults than in newborns, carries a potential risk of complications and severe consequences).
    • Bladder fullness( urination in the baby does not happen often, but the volume of the separated urine is higher than the prescribed one).

    Most often, children have pyeloectasia as an innate phenomenon. With the expansion of pelvis and calyx, one can speak of hydronephrosis transformation of the kidneys or pyelocalicectasia. Expansion of the pelvis and ureter is called ureteropyeloectasia, ureterohydronephrosis or megaurethra. This disease occurs 3-5 times more often in boys than in girls. It happens, as one-sided, and bilateral pyloectasis of the kidneys in the fetus. Severe forms of the disease require surgical intervention, and light forms pass by themselves.

    This is important! Such term as "pyeloectasia" in medicine is used for the purpose of denoting anatomical pathological expansion of renal pelvis. This disease specialists consider the initial stage of kidney hydronephrosis.

    Pyeloectasia - the causes of its appearance

    The cause of pyelonectasia of the kidneys in the fetus is that there is a weak outflow of urine from the cavity of the pelvis or its reverse entry into the kidney.

    There are such groups of causes that trigger the appearance of pathological processes:

    1. Congenital dynamic: neurogenic disorders of urination, stenosis, phimosis;
    2. Congenital organic: impaired renal ureter, upper urinary tract;
    3. Acquired dynamic: tumor processes of the prostate, urethra, inflammatory processes, for example, adenoma, narrowing of the urethra, hormonal disorders, diabetes mellitus;
    4. Acquired organic: tumors of the genitourinary system, Ormond's disease, narrowing of the ureter due to trauma or inflammation, kidney failure.

    Symptoms of pyeloectasia

    Pyelonectasia of the kidney is a disease that can flow absolutely imperceptibly. Patients may be troubled by symptoms of the disease, which is the result or cause of enlargement of the renal pelvis, for example, functional kidney failure, pyelonephritis.

    Very often, pyelonectasia is accompanied by such diseases:

    • With ureterocele, ureteral bladder proliferation occurs and it enters the bladder,
    • Ectopic ureter( in boys ureteral flow into the urethra, and in girls - into the vagina).
    • Megaureter. A consequence of the disease is a sharp increase in the size of the ureter.
    • Bladder ureter reflux is a condition through which the urine flow from the urea back to the kidney. With repeated ultrasound, you can fix the change in the size of the pelvis, since the disease changes its dimensions in a specific way.
    • Pyelonephritis, cystitis - diseases caused by stagnation of urine in the pelvis.

    Pyeloectasia in a child and fetus

    Often in children, such a pathology is innate. The disease is more common in boys than in girls. Adverse factors associated with the urinary system provoke pyelonectasia in the fetus and the newborn. Since there is a violation of the outflow of urine, the tissue of the kidneys is squeezed and their functioning decreases. Also, the overall structure of the organ may change.

    This pathology can be detected with ultrasound at 16-18 weeks gestation. If a newborn has symptoms of a urinary infection, the specialist prescribes a complete urological examination: a radioisotope study of the kidneys, cystography, excretory urography. Based on these data, the doctor establishes a diagnosis, finds out the causes of a decrease in the outflow of urine and the severity of the disease. The next step is to decide on the treatment of the child.

    Pyelonectasia of the kidney in a child can cause such pathologies:

    • weakness of the muscular apparatus in premature babies;
    • ureteral transfer by large blood vessels or neighboring organs;
    • as a result of uneven growth of organs, ureteral transfer occurs;
    • The presence of neurogenic bladder dysfunction( rare urination with large volume of excreted urine, permanent overflow of the bladder)

    How to treat the disease in adults and children

    According to experts, there are three forms of this disease that determine the severity of the course: light, medium and heavyThe pathology can develop both in both the kidneys and in the left kidney or the right kidney in the fetus. In case of illness, not only pelvic can be affected, but also a ureter with kidney cups, this depends on the shape of the bob

    Before the start of treatment, it is necessary to find out the causes of the onset of the disease and the degree of its severity. In children, such a pathology of mild and moderate severity can become less pronounced or disappear altogether. At the moment, the question of whether the disease will progress after the birth of the child is veryIt is believed that the pyeloectasia of both kidneys in the fetus is a physiological phenomenon that is associated with the immaturity of the urinary system.

    With the expressed form of pyeloectasia with progressive course and decreased kidney function, surgical treatment is necessary. Statistics suggest that surgical intervention is necessary in 25-40% of cases of the disease.kidney in a child can provoke inflammation. For this purpose, before the operation, specialists prescribe to patients drugs of plant origin that destroy microorganisms falling into the urine.

    This is important! It is necessary to observe appointments of specialists during pregnancy, to limit the amount of fluid consumed. It is also necessary to timely treat ureteral diseases.

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