So baby Wesley has had some problems with his little kidneys being a little dilated so I've had to go in and get some extra ultrasounds done to see if there has been any change. All the measurements were "ambiguous" (which was the doctors favorite word every time we went in there) meaning they didn't say either way if it was above normal or if it was in fact getting better, so I went back for three ultrasounds to keep checking. On the last one because I am so close to my due date and the measurements were still "ambiguous", they are going to have little Wesley come in a little while after he is born to see what's happening. Here is some information about Pyelectasis if you'd like to learn more about it, if not skip down to the ultrasound pictures.


Fetal Pyelectasis (Pelviectasis)

Enlargement of the part of the kidney that collects urine (the renal pelvis) from 4 to 10 millimeters in diameter is called fetal pyelectasis or “renal pelvic dilatation”. Dilation of the renal pelvis to greater than 10 mm is called severe pyelectasis or hydronephrosis. The illustration at right shows a normal kidney compared to a kidney with pyelectasis.

Normal Pyelectasis
Pyelectasis is detected in 1 per 100 babies before birth, and is seen more commonly in male fetuses [14]. About 1 in 500 cases develops significant disease. Most mild cases resolve before birth or within a few months after delivery [1,2].
A fetus with severe pyelectasis or hydronephrosis is at increased risk of developing problems such as low amniotic fluid and kidney disease. In addition pyelectasis has a weak association with chromosome abnormalities, in particular Down syndrome [3,4]. The severity of isolated pyelectasis does not appear to increase the risk for chromosome abnormality [5].

What Causes It?

The most common causes of severe pyelectasis or hydronephrosis are a blockage of the ureter (the tube that carries urine from the kidney to the bladder) where it joins the kidney and backward flow of urine from the bladder (vesicoureteric reflux) [6]. Less common causes of hydronephrosis include posterior urethral valves, urethral atresia, ectopic ureteroceles, duplication of the collecting system, megacystis-microcolon-intestinal-hypoperistalsis syndrome, prune belly syndrome, and cloacal malformation.

Does Pyelectasis Need Treatment?

Pylectasis involving only one kidney does not need intervention, but requires followed up ultrasound evaluation after 28 weeks for possible worsening of the condition. Severe hydronephrosis involving both kidneys is associated with increased risk of poor outcome, and is monitored for the development of low amniotic fluid [11].

An ultrasound is usually done 5 to 7 days after birth to reevaluate the infant’s kidneys. Most cases of mild pyelectasis where the renal pelvis measures less than 8 mm and involves only one kidney tend to resolve spontaneously either in utero or within a few months after delivery. Pyelectasis greater than 8 mm is more likely to need surgical correction during childhood [7-10].


What are the Chances of Having Pyelectasis Again in a Future Pregnancy?

In a study of 64 women with the finding of pyelectasis in their fetuses, 43 (67%) had a recurrence of this finding in their next pregnancy [15].


What is the Risk of Down Syndrome in a Fetus with Pyelectasis?

Presently genetic testing of the fetus (amniocentesis) is offered if the risk of Down syndrome in the fetus is 1 in 190 or greater. For a 34 year old woman the isolated finding of pyelectasis at midtrimester increases the risk of Down syndrome from 1 in 365 to 1 in 192.

For a woman 34 years of age or less with a normal triple marker screen for Down syndrome the risk benefit ratio does not favor amniocentesis when the only ultrasound finding is pyelectasis [12,13].

These are some really cute profile pics. I love the one of him sucking his thumb.




Here are a couple shots of the kidneys. The two black areas in the middle of the white circle are his kidneys.


On Thursday night of this week I started having some Braxton Hicks contractions around 3:30 and although usually annoying and little painful after about an hour or so they got much worse and I started to wonder if they weren't Braxton Hicks anymore. I was doubled over and doing the contraction waltz while I made dinner. They lasted for two hours. Well luckily on Friday I had a doctors appointment so I told her about the contractions and along with some other info like I'd lost a pound and the uterus was measuring small at 33 1/2 cm instead of the 36 that I should be, she had a non stress test done on little Wes to see if he was doing ok. So in the twenty minutes that they monitor him he was kicking and rolling around and his heart rate was excellent and went up when he moved like it should, so he is doing just fine. I am a little anxious though that he might come early, although I'm totally ok with him staying in there as long as he wants to.