When you're expecting a baby, it's normal to worry about your baby's health. Sometimes, during scans, doctors can see small changes in your baby's kidneys, such as a small swelling. You might be a little scared when you hear that. That's what pyelectasis is. But don't worry, we'll keep everything simple.
What is Pyelectasis?
Simply put, pyelectasis is when your baby has a small amount of urine in the middle of one of their kidneys while they're still in the womb. To be precise, the main area of the kidney where urine collects is the one that looks a little swollen.
This is caused by a small blockage, or obstruction, in the path of urine produced in the kidneys, which travels down the ureter (also called the ureter) to the bladder. Or, sometimes, urine flows back up from the bladder, toward the kidneys (`Urinary reflux`).
Doctors sometimes refer to this condition as pyelectasis, pelviectasis, pelvocaliectasis, or caliectasis, depending on where the urine collects. But all of these terms refer to a collection of urine in some part of the kidney.
What is the difference between Pyelectasis and Hydronephrosis?
Both of these names refer to the kidneys becoming swollen with urine, but there is a slight difference.
- In pyelectasis , the obstruction in the urinary tract is usually mild . Therefore, a small amount of urine accumulates in the kidney. This causes a slight enlargement of the middle part of the kidney.
- In hydronephrosis , this blockage is more severe, meaning it is severe . Then a lot of urine accumulates in the kidney, and in some severe cases, the kidney can swell like a balloon.
Most of the time, pyelectasis will resolve on its own without any treatment . However, in about 10% of cases, it can progress to hydronephrosis. In this case, you may need to see a pediatric nephrologist or urologist after your baby is born.
How common is this condition?
Pyelectasis is a relatively common condition . It occurs in about 1 in 40 pregnancies. It can affect only one kidney (unilateral pyelectasis) or both kidneys (bilateral pyelectasis).
Just think, male babies are about three times more likely to develop this condition than female babies .
Is Pyelectasis serious?
In most cases, pyelectasis does not have any major adverse effects on your baby. The majority of babies with this condition are born healthy and do well.
However, very rarely, this condition of pyelectasis can develop into a severe condition called hydronephrosis. In that case, doctors may recommend surgery (fetal surgery) while the baby is still in the womb to prevent damage to the baby's kidneys. However, this is very rare.
Is this related to Down syndrome?
If your baby's ultrasound scan shows that he or she has pyelectasis, there is a slightly higher chance that the baby has a chromosomal condition called Down syndrome . However, this does not mean that every baby with pyelectasis has Down syndrome. In fact, the majority of babies with pyelectasis do not have Down syndrome.
Simply put, if pyelectasis is not accompanied by other abnormal blood test results or other abnormalities on the scan, it is often considered a minor change in the normal development of the fetus.
What are the symptoms?
Pyelectasis during pregnancy often has no symptoms . This condition is usually discovered during your scheduled prenatal ultrasound scans.
What causes pyelectasis in the fetus?
There are two main reasons.
1. Ureteropelvic junction obstruction:
What happens in this case is that there is a blockage or obstruction at the point where the tube that carries urine from the baby's kidney (called the `ureter`) connects to the kidney (called the `ureteropelvic junction`). Then, urine cannot flow out, that is, into the urethra, and gets stuck inside the kidney. Due to this blockage, the pressure inside the kidney increases, causing pyelectasis, and over time, kidney function can decrease.
2. Vesicoureteral reflux:
Normally, urine produced in the kidneys travels down the ureters and collects in the bladder. It then leaves the baby's body and enters the amniotic fluid in the womb.
However, sometimes, urine from the bladder flows back up, that is, along the ureter to the kidneys . This is called vesicoureteral reflux. If the urine that flows back up in this way gets stuck in the kidneys for too long and causes swelling, it can also cause pyelectasis.
How do you find this?
Doctors diagnose pyelectasis during a prenatal ultrasound scan . If your scan shows it, you and your baby will need to be monitored closely throughout your pregnancy.
What are the treatments?
The good news is that in most cases, pyelectasis resolves on its own without any special treatment.
Your doctor will monitor this condition throughout your pregnancy. If necessary, your baby will be examined by a pediatric urologist or a pediatric nephrologist after birth.
In some cases, a pediatric urologist may perform a surgical procedure called pyeloplasty , which is used to relieve a blockage between the kidney and the ureter.
During pregnancy, doctors may recommend fetal surgery only if the condition, such as pyelectasis or hydronephrosis, is severe enough to cause kidney damage. However, this is very rare .
Can I reduce this risk for my baby?
Pyelectasis is a small change in the development of the fetus, so there is really no way to prevent it from occurring . However, it is essential to have regular ultrasound scans during your pregnancy. This is when your doctor can monitor the condition and recommend treatment if necessary.
What happens if my baby has pyelectasis?
If your doctor finds that you have pyelectasis on a scan, you and your baby will likely be monitored during your pregnancy and after your baby is born. Your doctor will do regular scans to see if the blockage gets worse.
If pyelectasis worsens and becomes hydronephrosis, you will need to see a pediatric urologist or a pediatric nephrologist after your baby is born. They will examine your baby and decide if treatment is needed.
Very rarely, the blockage caused by pyelectasis can be severe enough to damage the kidneys while the baby is still in the womb. If this is suspected, your doctor will talk to you about fetal surgery.
Can Pyelectasis be cured?
Yes, absolutely! In more than 90% of cases, pyelectasis gets better on its own . If the blockage is severe, surgery may be needed to correct the problem.
Babies with severe hydronephrosis are more likely to have ongoing problems after birth. In such cases, your baby may need surgery.
When should I see the doctor?
It is very important to attend your regular medical check-ups and scans. Doctors can only diagnose pyelectasis with an ultrasound scan. They will monitor your condition closely and recommend treatment if necessary.
What questions should I ask the doctor?
If your scan shows you have pyelectasis, you can ask your doctor questions like:
- Does the baby have a kidney blockage? If so, where is it?
- Do you have urinary reflux?
- Is this congestion mild, moderate, or severe?
- Is there anything else on my scan or blood tests that suggests the baby may have Down syndrome or another chromosomal condition?
- How likely is it that my baby will need surgery?
Take-Home Message
It's normal to feel scared and worried when you find out that your baby has pyelectasis. But in most cases, all that's needed is observation . Your doctor will run the necessary tests to see if this is an isolated problem or a symptom of another condition. They will be monitoring your condition closely and will help you every step of the way. So don't be unnecessarily scared. The most important thing is to follow your doctor's instructions.
` Pyelectasis, fetal kidney, hydronephrosis, prenatal ultrasound, ureteropelvic junction obstruction, vesicoureteral reflux, baby health, kidney swelling, pregnancy health
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