After the tech finished the ultrasound, I was moved to the exam room to wait for a midwife. As we wrapped up our discussion "normal" pregnancy ailments, such as extremely achy hips, she said something along the lines of, "So we picked up a little issue with baby's kidneys on this ultrasound. It's probably no big deal, it's called dilated renal arteries, but you'll need to go have another ultrasound at the perinatologist's office where they'll take a better look."
"Huh? What now," I asked, totally thrown off by this information.
"Things are measuring a bit larger than normal. Probably no big deal, but we have to take another look," she replied. "Especially because this didn't show up on the 20-week ultrasound."
I did a bit of light Googling and asked other medically inclined friends for information, but neither source had much insight. I even called to make sure I had the right description of the issue. They repeated the same information, calling it dilated renal arteries.
After our appointment with the perinatologist, the doctor present told us the issue was more accurately called "dilatated renal pelvis," a condition I HAD come across in my Googling.
Essentially, one of the baby's kidneys was measuring larger than it should, indicating it was retaining urine. This could be due to several reasons: a pinched ureter, a blockage, a faulty valve in the bladder or kidney, lack of gravity assisting the urine's escape from kidney to bladder.
The retention wasn't significant, but more than "normal." Of course we hoped for the gravity issue, but needed to get it checked out once baby was born.
Surgery could be a possibility, depending on the severity of cause of the dilatation.
The concern is that if there is a blockage or other cause for the enlargement is that it will lead to urinary tract infections, kidney infections, stones and the like. It's hard for little kiddos to tell you they don't feel well in those areas, so the general thinking in the medical world is to fix the issue now rather than when there is a bigger issue later.
Emmett peed beautifully a few times before they came and took him for an ultrasound. The pediatrician in the hospital was amazing and spent a lot of time talking to us to explain more about the situation, what he was doing to get some tests done and how they would have had no idea about there being a possible problem if we hadn't told them in the first place. Emmett was otherwise well, healthy and perfect.
A couple days after his birth we took him to the children's hospital where they inserted a catheter into his little (ehem) penis and pumped fluid into his bladder to see where it went. We watched the screen as the fluid filled his bladder and stayed there, indicating there were no issues with the valves from the ureters to the kidney, so there was nothing wrong with the bladder, yay!
A few days later, we met with a urologist at the children's hospital, images of the test in hand for their review. The PA made me cry about three seconds after she entered the room after we told her about how Emmett had an ultrasound in the hospital. She began shaking her head and telling us we shouldn't have done that [cue tears] because mom's hormones are still pumping through baby's body and the issue could simply be extra hormones.
Well, being just three days postpardum, I couldn't stop crying. I sobbed the whole time we were there. I simply could not stop. I was afraid something was wrong with him, I was afraid we were putting him through tests for no reason, I was worried something would happen to his little (ehem) penis because of all the poking and prodding. Mostly, I was upset with how the PA marched in and told us we were doing everything wrong when all the other doctors had told us what we were doing was ok and normal. No one once mentioned anything about things being done out of order or unnecessarily.
Anyway, the PA and urologist explained that we'd need to have two more tests done in 30 days.
Thirty days later I took Emmett back to the children's hospital for a MAG3. This time they used an IV to pump him full of fluid that would fill up his kidneys to see where it would go, then monitored to see how quickly they'd go from full to half full. Draining slower than 10 minutes is indicative of a problem; Emmett's drained in 3.5 minutes!
Here are Emmett's kidneys and bladder all lit up from the fluid that was injected. I got to stay in the room with him while he was strapped to a little table. He did beautifully, considering all the tubes, needles and swaddle!
The next week we went for a follow-up ultrasound to measure the size of the kidneys. The results:
Right kidney function: 57%
Left kidney function: 43%
This was overall good. They found no obstruction, but it's clear the right side still indicated mild dilatation (normal function is 50/50...).
Basically, there is still a slight enlargement of one kidney, but nothing to be concerned about at all. Everyone has one that's a little bigger than the other! We do go back in January to make sure nothing has changed significantly, but otherwise we are done with all that kidney business. Thank you, God!
We go back for another ultrasound in early February to make sure nothing has changed. After that, pending good results, we'll be done.
Next up: why Emmett has blood in his poop. Wheeeeee......
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