This expansion is observed in 1-4 percent of pregnancies.
However, only one in 500 causes a serious problem. If the baby has an enlarged
renal pelvis, the probability of a urological (urinary tract) problem
increases. In addition, pyelectasis has a weak relationship with some
chromosomal abnormalities, especially down syndrome. In more severe
hydronephrosis, the risk of an abnormality related to the urinary system
increases. However, the severity of pyelectasia does not increase the
likelihood of chromosomal abnormalities.
Even in mild hydronephrosis (4-10 mm, grade 1.2) there is a
relationship with down syndrome and other chromosomal anomalies. Therefore, in
the presence of mild pyelectasis, the presence of another anomaly that may
cause down syndrome suspicion with detailed ultrasonography should be
investigated. The opinion of scientists is that if no anomaly other than
hydronephrosis has been detected and there is no other risk factor, it is not
necessary to perform amniocentesis for genetic examination. Because there is no
other condition such as advanced maternal age or risky triple-quad test, the
risk of Down syndrome is low (less than 1 in 300) only in the presence of
hydronephrosis. If the mother's age is over 35, another anomaly other than
hydronephrosis has been detected (renal or extrarenal), if there is a high risk
in the tests, genetic examination with amniocentesis is recommended.
What is the
cause of hydronephrosis?
If pyelectasis persists after birth, it is usually the cause
of a blockage or vesicoureteral reflux (urine leak from the urine bag to the
kidney) where the ureter (the ureter: the tubular structure that carries urine
from the kidney to the urethra) joins the kidney pelvis.
More rare causes are urological abnormalities such as
posterior urethral valve, urethral atresia, ectopic ureterocele, and double
collection system.
Follow-up
and treatment of hydronephrosis:
Hydronephrosis in the baby should be monitored with
ultrasound at intervals to increase or decrease during pregnancy. If both
kidneys have severe pyelectasis or hydronephrosis, it is a more risky
condition, and the water must be monitored, as the baby's water may decrease.
In case of excessive oligohydramnios, preterm delivery may be required. As the
pregnancy progresses, if the renal pelvis width increases and the width is
bilateral, the possibility of damaging the kidney increases. After birth, the
baby's kidneys should be re-evaluated with ultrasound. In cases where the
enlargement is low and it is in one kidney, it either improves before birth or
usually resolves spontaneously in a few months after birth. However, if the
enlargement is large, surgery is usually required in childhood. It is decided
whether surgery is required with ultrasound measurements after birth and some
tests.
-CHOROID PLEXUS CYST
-CORPUS CALLOSUM AGENESIS (CCA)
-MEGA SISTERNA MAGNA
-MEGALENCEPHALY
-MICROCEPHALY
