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Wednesday, March 12, 2014
Urinary and Genital Disorders (Children)
28 week Ultrasound - blockage in both kidneys
At 19 weeks there was one cyst in one kidney. Today there were multiple cysts and a blockage was confirmed. There is a good amount of fluid. there is swelling of the kidneys. my doctor was uncertain. i am having another ultrasound in 1.5weeks to see if there is more swelling and if there will be damage to the kidneys. what does this mean? I also may have diabetes and have to be tested.
You are asking a difficult question because the images and full description of the problem are not available to review. A blockage of the kidney can occur at the junction between the ureter and the kidney or lower down where the bladder drains. The blockage between the ureter and kidney can occur on one or both sides. A blockage of the bladder outlet almost always is in a boy and would affect both kidneys. The finding of cysts often is an indication that that particular kidney has poor function. If there is a satisfactory amount of amniotic fluid around the baby, then often they do fine after delivery. On the other hand, if the volume of amniotic fluid decreases significantly, then lung development, which is stimulated by amniotic fluid, may be abnormal. It sounds like you need close monitoring and your case probably should be discussed at a perinatology meeting at a major medical center.
As an alternative, it might be a good idea to meet with a pediatric urologist, who could discuss the various diagnostic possibilities and postnatal evaluation and management with you.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University