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What does Fetal pyelectasis in an ultrasound during pregnancy indicate?

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Posted on Tue, 12 May 2015
Question: Hi, I am 39 weeks pregnant...I was just given an ultrasound to check amniotic fluid level last week...dr. told me everything checked out. However, I was mailed the results today, and whilr AFI levels are fine, it also states that ' borderline pelviactasis is found in both kidneys, 7mm on the right, 8 mm on the left..this is a new finding' I don't understand why this wasn't presented to me...I've done a bit of research and see it is a soft marker for downs? Is it unusual to find this when I'm so far along, as my 21 week scan showed nothing? Thanks for any advice
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Answered by Dr. Deepti Verma (23 minutes later)
Brief Answer:
Unlikely to have any problem

Detailed Answer:
Hi XXXXX, I have gone through your question and understand your concerns. Fetal pyelectasis is the dilatation of the renal collecting system including renal calyces and renal pelvis. It has diggerent cut-off values for different trimesters. For third trimester, the cut off value is 7mm; if it is more than 7 mm then it is called as renal pyelectasis.
Renal pyelectasis in fetus can be due to:
1. Obstruction in the renal tract, usually mild
2. A soft marker for fetal chromosomal anomalies, especially Downs syndrome, and such soft markers are usually visible in second trimester ultrasound.
3. Associated with other genetic syndromes.
Since your ultrasound at 21 weeks was absolutely normal, with no other anomalies or soft markers mentioned and the pyelectasis developed late in third trimester, and that too borderline, it is more likely due to some mild obstruction in the renal tract.
It is very unlikely to be chromosomal anomaly or any other genetic syndrome, if no other congenital anomalies are seen and amniotic fluid is normal.
I would suggest you to deliver at a tertiary care centre, with a facility of pediatric urolologist. The neonate should be evaluated with post natal renal ultrasound and if pyelectasis is still there, then a micturating cystourethrogram should be done to detect the obstruction in renal tract.
If any other features of chromosomal anomalies are suspected in the newborn,which is very unlikely, a karyotype should be done.
I suggest you not to worry as your fetus is most probably absolutely normal.
Be positive and hopeful.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Deepti Verma (19 minutes later)
Thank you so much
doctor
Answered by Dr. Deepti Verma (4 hours later)
Brief Answer:
Best wishes

Detailed Answer:
Hi XXXX, thanks for responding.
Best wishes,
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

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What does Fetal pyelectasis in an ultrasound during pregnancy indicate?

Brief Answer: Unlikely to have any problem Detailed Answer: Hi XXXXX, I have gone through your question and understand your concerns. Fetal pyelectasis is the dilatation of the renal collecting system including renal calyces and renal pelvis. It has diggerent cut-off values for different trimesters. For third trimester, the cut off value is 7mm; if it is more than 7 mm then it is called as renal pyelectasis. Renal pyelectasis in fetus can be due to: 1. Obstruction in the renal tract, usually mild 2. A soft marker for fetal chromosomal anomalies, especially Downs syndrome, and such soft markers are usually visible in second trimester ultrasound. 3. Associated with other genetic syndromes. Since your ultrasound at 21 weeks was absolutely normal, with no other anomalies or soft markers mentioned and the pyelectasis developed late in third trimester, and that too borderline, it is more likely due to some mild obstruction in the renal tract. It is very unlikely to be chromosomal anomaly or any other genetic syndrome, if no other congenital anomalies are seen and amniotic fluid is normal. I would suggest you to deliver at a tertiary care centre, with a facility of pediatric urolologist. The neonate should be evaluated with post natal renal ultrasound and if pyelectasis is still there, then a micturating cystourethrogram should be done to detect the obstruction in renal tract. If any other features of chromosomal anomalies are suspected in the newborn,which is very unlikely, a karyotype should be done. I suggest you not to worry as your fetus is most probably absolutely normal. Be positive and hopeful. Hope you found the answer helpful. Please do get back for further queries. Wishing you good health. Regards, Dr Deepti Verma