How is urinary tract dilation managed before birth?
Urinary tract dilation is not treated before birth if the amniotic fluid level remains normal. After the condition is diagnosed, however — usually as a result of the ultrasound done routinely at the 20th week of pregnancy — we may continue to monitor your baby with high-resolution fetal ultrasonography at intervals throughout the pregnancy.
What is high-resolution fetal ultrasonography?
High-resolution fetal ultrasonography is a non-invasive test performed by one of our ultrasound specialists. The test uses reflected sound waves to create images of your baby within the womb. We will use ultrasonography to follow the development of your baby’s urinary tract and other internal organs, as well as his or her overall growth. We will also use it to measure the volume of amniotic fluid that surrounds the baby throughout the pregnancy.
What happens after my evaluation is complete?
After we have gathered all the anatomic and diagnostic information about your baby, our maternal-fetal specialist will meet with you to discuss the results and share our recommendations. We will connect you to a nurse specialist care coordinator who will assist with setting up future consultations and follow-up care for the baby after birth. One of those consultations will be with a pediatric urologist, who will meet with you either during the pregnancy or soon after the baby is born. We will also communicate with your primary obstetrician or midwife so that he or she can continue to provide your routine prenatal care.
How is urinary tract dilation treated after birth?
Urinary tract dilation does not change when or how you deliver. Your baby will not need to be delivered early. Nor will your baby need to be delivered by cesarean section, although, like all women, you may need early delivery or a C-section for other obstetric reasons. It is also very likely that you will be able to deliver your baby with your primary obstetrician or midwife at your local hospital.
If your baby has very dilated kidneys, however, or has low amounts of amniotic fluid (oligohydramnios), he or she may need specialized medical care after birth in a newborn intensive care unit (NICU). In such a case, we recommend your baby be born at The Mother Baby Center at Abbott Northwestern and Children’s Minnesota in Minneapolis or at The Mother Baby Center at United and Children’s Minnesota in St. Paul. Children’s Minnesota is one of only a few centers nationwide with a birth center located within the hospital complex. This means that your baby will be born just a few feet down the hall from our NICU.
We will assist you with scheduling a visit with a pediatric urologist during the first few weeks of your baby’s life. At that time, your baby will have an ultrasound of his or her kidneys and bladder — and possibly other testing — to see if the baby will need any post-birth treatment.
Will my baby need an operation?
In many cases, no treatment is needed, as the condition resolves on its own without any long-lasting medical problems. An antibiotic is sometimes prescribed, however, to prevent a urinary tract infection.
If your baby has advanced urinary tract dilation (UTD A2-3), surgery may be needed to correct the underlying structural problem that is blocking the normal flow of urine. To prevent lasting kidney damage, the surgery is usually done before the child’s second birthday.
What is my baby’s prognosis?
Most babies with urinary tract dilation have an excellent prognosis. Usually, the urinary tract dilation resolves on its own completely after birth. In cases where the condition is due to a structural blockage, surgery can often fix the problem.
Will my baby require long-term follow-up?
The findings from your baby’s ultrasound taken after birth will determine whether or not follow-up care with a pediatric urologist is needed. Such care, which may include surgery, can decrease the risk of kidney problems for your baby later in life. The pediatric urologist will recommend an individualized management plan for your baby based on your baby’s specific ultrasound findings.
Need a referral or more information? You or your provider can reach the Midwest Fetal Care Center at 855-693-3825.