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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant, Blockage In The Kidney, Swelling, Rbc Count Is Low, 37 1/2 Weeks Pregnant. Is The Delivery Advisable?

Hi Doctor, my daughter is 36 weeks pregnant and for the last 2 months has been having trouble with her right kidney, scans show a blockage, but the hospital has not worried about the kidney, they say they are more concerned about the baby, She has been admitted to hospital today, scans are showing that her kidney is really swollen and her Red Blood Count was low, only 107 (her hemoglobin). Her uterus is showing that she is 37 1/2 weeks pregnant. They have put her on a drip with anitbiotics. This morning she had a show of blood and brown stuff. Is it to early to have the baby now ( she is having a C section.
Mon, 3 Jun 2013
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General & Family Physician 's  Response
Hello,
Thanks for posting the question to H.C.M. Forum.
As ultrasound indicates that size of uterus is 37 1/2 weeks .
Presumed that the condition of fetus is nice, so this is most appropriate time to have delivery ( manual or C section).
As hemoglobin mentioned in the query is not clear but it seems that it is 10.7 gm % , if that , than at once take a decision.
This is good hemoglobin level for delivery.
As kidney is swollen and there is blockage ,so doctor have to take a decision about kidney also.
After delivery doctors would be free fro the treatment of kidney trouble.
Hope I have answered your query.
If further any question I will help.
Good luck.
Dr. HET

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General & Family Physician Dr. S. Jegadeesan's  Response
Hello,
Thanks for the inquiry,
Now your daughter is 36 weeks pregnant, and she is having a blockage in her right ureter (common in the right side) producing enlargement of the right kidney (hydronephrosis), for the last 2 months. Today she is admitted to the hospital and C Section is planned for her. Today's scan report reveals the size of fetus as 37 1/2 week. So she may be taken up for C Section any time from now. 37 1/2 is not an early period for C Section.
The block in the ureter may be due to
1) Compression of ureter by enlarged uterus
2) Hormonal changes like increased level of progesterone and estrogen during pregnancy which cause an increase in the blood flow - causing further blockage in the ureter
Treatment:
Depends upon the pressure over the ureter and amount of kidney damage.
As long as the kidney is secreting urine nothing to worry. Only if the block is severe and kidney is about to go for failure (to be assessed by Blood urea, Serum creatinine, Serum Biochemical analysis and urine analysis) a ureteroscopy and keeping a stent may be needed. For your daughter NO need.
If no stone is blocking the ureter and pregnancy is only reason for block and by your description I think wait for delivery. Delivery will relieve the blockage and hydronephrosis will be brought down instantly.
The Hb level shows little anemia which can be corrected at any time. During pregnancy it is interrelated with BP.
Delivery is the only remedy for all the troubles. Moreover C Section is planned. So nothing to worry about.
Rest, Plenty of water, Lying on one side which is comfortable for her is advised
Wishing your daughter a safe C Section and to recover from her troubles.
Warm regards to all


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Pregnant, Blockage In The Kidney, Swelling, Rbc Count Is Low, 37 1/2 Weeks Pregnant. Is The Delivery Advisable?

Hello, Thanks for posting the question to H.C.M. Forum. As ultrasound indicates that size of uterus is 37 1/2 weeks . Presumed that the condition of fetus is nice, so this is most appropriate time to have delivery ( manual or C section). As hemoglobin mentioned in the query is not clear but it seems that it is 10.7 gm % , if that , than at once take a decision. This is good hemoglobin level for delivery. As kidney is swollen and there is blockage ,so doctor have to take a decision about kidney also. After delivery doctors would be free fro the treatment of kidney trouble. Hope I have answered your query. If further any question I will help. Good luck. Dr. HET