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Pregnant. Scan shows mild prominence of bilateral pelvicalyceal system in baby's kidney. Need explanation

hello Dr,i am 36 week & 4 days pregnant, my scanning report shows baby s kidney , mild prominence of bilateral pelvicalyceal system noted.( Renal pelvis AP diameters-5.5 mm in AP dimension). Amniotic fluid volume is normal. Please inform me the consequence of after my delivery and my baby s condition,explain this situation.
Asked On : Tue, 1 Jan 2013
Answers:  1 Views:  821
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OBGYN 's  Response
Mar 2013
Thanks for your query
Fetal pyelectasis (FP) refers to a prominence / dilatation or the renal pelvis in utero.

Fetal pyelectasis can be a relatively common finding in an antenatal ultrasound scan, often detected at the routine 2nd trimester morphology scan. It affects male fetuses more . The estimated prevalence is at ~ 2% of routine second trimeter scans

Pyelectasis can result from a number of factors. In the majority of cases, it is physiological and resolves spontaneously, so you need not worry too much.
However, it may also herald the presence or evolution of renal tract pathology, such as :

fetal PUJ obstruction
fetal VUJ obstruction
urethral obstruction - e.g. posterior urethral valves
vesicoureteric reflux
duplex kidney
Associations with trisomy 21: presence and strength of this association is currently under debate and at best considered very mild.
Following are the cut off values for defining prominent fetal renal pelvis :

> 4 - 4.5 mm at 18 - 20 weeks (i.e. the routine 2nd trimester)
> 5 mm at ~ 20 - 29 weeks
> 6 mm at 32 weeks
persistent fetal pyelectasis : > 7 mm in the 3rd trimester

The vast majority of cases (~ 96%) with mild pyelectasis in the second trimester resolve, either during pregnancy itself or in the early postnatal period, however serial monitoring with ultrasound is the best approach, you need to worry if there is

increasing degree of pelvic dilatation
in-utero progression
bilateral involvement

Please act in concert with your treating obstetrician and also seek the opinon of a pediatric surgeon, or a neonatologist, who would also guide you accordingly . Your case is borderline ( very mild ) as the cut off values suggest.
Please dont worry.
Answered: Wed, 2 Jan 2013
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