Pre-natal Counseling

Pre-natal Nephrology Evaluations

The Children’s Kidney Center offers comprehensive pre-natal nephrology consultations for women diagnosed with abnormal fetal renal sonograms. The consultation involves discussion about the diagnosis, outcome and management options. These consults include pre-natal evaluation of maternal disorders that may affect the fetus or of babies with a significant renal anomaly or urinary tract problem noticed intra-utero.

Renal fetal anomalies can be associated with genetic disorders, isolated malformations or part of a complex syndrome. Early consultation allows the parents to understand the differential diagnosis and potential outcome of the fetus. Detailed explanation is provided regarding post-natal evaluation, surgical procedures that may be required, nutritional requirements and “renal protection” measurements that would impact in the renal outcome and optimize the growth and quality of the child’s life.

The Children’s Kidney Center uses a multi-disciplinary approach, integrating various medical specialist groups such as Maternal-Fetal Medicine, Pediatric Urology, Neonatology and Social Work Services.

Pre-natal Hydronephrosis

Antenatal ultrasound has revolutionized the diagnosis and management of conditions such as hydronephrosis, and appropriate therapy may prevent the ensuing complications of pyelonephritis and obstruction. A diagnosis of pre-natal hydronephrosis may be made in up to 1% of newborns and in 20% of these, the condition is significant. Most often, the cause is transient in-utero obstruction. An anterior-posterior diameter of the fetal renal pelvis >2 cm by ultrasound is predictive of significant urologic pathology and such patients may require surgical intervention and/or long-term urologic care. Of note, most infants are asymptomatic at birth. Post-natal imaging should be considered in those infants with bilateral hydronephrosis, posterior urethral valves, and complicated duplex or double drainage systems that can lead to infection and possibly obstruction.

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