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What are the implications of hydronephrosis in the fetus?

Q: My wife conceived after laparoscopy and is 29 weeks pregnant. An ultrasound shows small echogenic foci in the left lateral ventricle, size 3 mm. Mild degree of hydronephrosis is seen in the left kidney and moderate degree of hydronephrosis is seen in the right kidney. No other obvious anomalies were detected. Our gynaecologist said its a minor problem and referred us to a paediatrician. Please brief me more about the report. What corrective action can be taken and whom should I approach. Will the baby be normal?

A:Hydronephrosis and echogenic foci in the left ventricle are often transient normal variants in the developing fetus. Occasionally, however, they are minor markers for Down's Syndrome, a chromosomal disorder associated with mental and physical disabilities. In order to identify the risk in this individual case the following additional information is required: The age of the pregnant mother; thickness of the nuchal translucency if it was measured in a 11-14 weeks ultrasound scan; results of an ultrasound scan at about 20 weeks of pregnancy; results of the triple test in case it was carried out at any time between 15-20 weeks of pregnancy; anteroposterior diameter of the hydronephrotic renal pelves and the clarification whether the echogenic focus is in the lateral ventricle or the left ventricle. Only if these are all normorange can the current findings be disregarded. The hydronephrosis needs a two-weekly ultrasound follow up until delivery to exclude a progressive mechanical obstruction.

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