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Pregnant. Anomaly scan showed mild pelviectasis in both kidneys. What does this mean?

Mar 2013
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Hi Nirja, I am 26 years old and 21 weeks pregnant. I recently had anomaly scanning done which said "Both Kidneys shows mild pelviectasia measuring 3 mm on right side and 2 mm on left side. Bladder appeared normal". Is this something to be worried about? What does this mean exactly?
Posted Sun, 26 May 2013 in Pregnancy
Answered by Dr. Aarti Abraham 10 minutes later
Thanks for your query.

Mild renal pelvis dilation---dilation of between 5 and 9 mm---is a reasonably common finding among pregnancies of 20 weeks. Approximately one in 100 fetuses will be affected. Only 4 percent of cases of renal pelvis dilation will require further treatment after birth. If dilation is still present later in the pregnancy, your child will be offered a postnatal scan.

When an unborn baby's renal pelvis becomes dilated, this indicates that the pelvis is retaining urine---either it is not leaving the kidneys or it is flushing back to the kidneys up the ureter. This could be due to some sort of blockage or compression of the ureter. It could also be the result of a slight defect in the formation of the kidneys and ureter in very early pregnancy.

A diagnosis of mild renal pelvis dilation is extremely unlikely to cause any difficulties during the remainder of the pregnancy or in delivery. In the vast majority of cases found at 20 weeks, the problem will be temporary. Very occasionally the renal pelvis can continue to dilate, but this does not necessarily indicate further problems. The condition only becomes significantly worse if the dilation is severe---greater than 15 mm---or there is also a defect detected in the kidneys.

In cases of mild renal pelvis dilation, there is a chance that, once born, your baby may be more prone to infections of the urinary tract than other children. However, these should pose no significant risk with early diagnosis and proper treatment. Some studies have linked renal pelvis dilation with cases of Down syndrome, but it is important to remember that this link is very weak. Blood screening for Down syndrome in early pregnancy is far more reliable, and an ultrasound will find 50 percent of cases. If Down syndrome is still a concern, you should consider amniocentesis.

If renal pelvis dilation is present at 20 weeks, a further scan will take place at 34 weeks to assess the situation. By this time, the pelvis may no longer be enlarged. If dilation is still present, it is likely that your child will be offered a scan two to three weeks after birth; if an infection is then diagnosed, it will be treated with antibiotics. If the dilation has become severe---greater than 15 mm---or the kidneys are affected, then the baby may need a scan and surgical treatment after birth.

Please get your quadruple marker test done to know the risks of any associated abnormalities.
With minimum fullness of bilateral renal pelvis, chances are extremely high that your child would be most normal after birth.

Take care, feel free to discuss further.
All the best
Above answer was peer-reviewed by
Follow-up: Pregnant. Anomaly scan showed mild pelviectasis in both kidneys. What does this mean? 9 minutes later

Thanks for your reply. You have mentioned that - "Mild renal pelvis dilation---dilation of between 5 and 9 mm---is a reasonably common finding among pregnancies of 20 weeks." but in my case its around 2mm and 3mm respectively. Is this a major concern? Also, is it really required for me to go for a quadruple test. There is no history of any kind of abnormalities in our family. What are the chances of my baby having renal pelvicteasis after birth?
Answered by Dr. Aarti Abraham 14 minutes later
Hi again.
Yes mild renal pelvis dilatation is defined the way I wrote.
Hence I wonder why at your findings of 2 and 3 mm, it is being called that.
It doesnt qualify as renal pelvic dilatation at all.
A quadruple test would only reassure you.
As i said, if serial scans show increased dilatation or persistent dilatation in the third trimester, only then you need to worry about your baby.
Right now with the present findings, I see no cause of worry.
Please go through this.
Its a link where the matter is presented in relatively simple language :

Above answer was peer-reviewed by
Follow-up: Pregnant. Anomaly scan showed mild pelviectasis in both kidneys. What does this mean? 15 minutes later

Thanks again for the reply. I had a go through in the link above. I am bit worried about this paragraph:
"Down syndrome: Some studies have also
suggested that there may be an increase in the
risk for Down syndrome when mild renal dilation
is seen in both kidneys during pregnancy. "
which in my case they say its in both kidneys (although I agree its very mild about 3mm max). Isnt the down syndrome detectable during anomaly scanning? Should I go for a 4D ultrasound which would reveal this?
Answered by Dr. Aarti Abraham 36 minutes later
There are only some soft markers ( pointers ) for Down syndrome which are detectable in anomaly scan.
Quadruple marker would show the risk somewhat.
Definite diagnosis is only by amniocentesis.
Above answer was peer-reviewed by
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