Forewarned
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Dr. RAMESH BABU SRINIVASAN discusses the benefits of detecting kidney problems before birth.
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ONLY in 1970, it was found that kidney problems can be detected before birth. Since 1980, an ultrasound scan of the baby in womb became a common feature. Currently most pregnant women undergo one or two ultrasound scans during their pregnancy.
The first called "dating scan" is to confirm the pregnancy and assess the duration of pregnancy. The second called "anomaly scan" is to find out about the development of organs and identify any defects. In addition some pregnant women require more than two scans, and in this situation more details about the foetus become available. With increasing availability of ultrasound, kidney problems are being identified more and more frequently.
Pregnancy itself is a stressful period for both the parents. Breaking the news about a kidney problem in the unborn baby can lead to a lot of anxiety. Such parents benefit by "antenatal counselling". Here the nature of birth defect and the possible solutions are discussed with the parents. The parents can find out the outcome of the problem, the treatments available and whether it is serious enough to consider termination of pregnancy. In such a situation they can plan the timing and place of delivery.
A common kidney problem detected before birth is kidney stretching, medically known as "Hydronephrosis".
In a majority of cases, it affects only one kidney and tends to disappear over a period of time after birth. In such a situation, the parents can be reassured safely. The baby will require a series of ultrasound scans after birth.
Until it resolves, the baby will have to be on a small dose of antibiotic daily to prevent infection.
If the stretching affects both kidneys, then blockage to the urine pipe is possible. In a male child, this can be because of a valve-like blockage, which requires urgent treatment after birth. In this case the parents need to plan for the treatment after birth. Either way detecting kidney problems before birth and getting appropriate advice helps the parents deal with the situation.
For further details see
www.india.net/patients/paediatrics/Hydronephrosis.asp
E-mail: kidsdocs@sancharnet.in
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