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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For PUJ Obstruction In Fetus During Pregnancy

Dear all, My wife is pregnant and the baby has PUJ obs., she is in W29,we have been following the case, it is only the right kidney as shown by ultra sound, till W26,the right kidney was fine, and yesterday we ve been informed that the right kidney is started to being damaged because of the urine, the dilation now is 2.3 cm and was in W26 1.4 cm, please i need advice what to do urgently knowing that I’m living in the middle east. Thank you
posted on Fri, 14 Mar 2014
Twitter Thu, 1 Oct 2015 Answered on
Twitter Thu, 1 Oct 2015 Last reviewed on
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OBGYN, Maternal and Fetal Medicine,  's  Response
Hi puj obstruction happens because of outflow tract obstruction down stream. Because your foetus is 29 weeks and there is damage to the kidney it is critical we intervene. Even though the one kidney can do in adult life we do not know the functionalty just now. The increasing dilatation perse is not a worry it could be superimposed hormonal effect but back pressure on the kidney is a concern.at the same time lung maturity is low at this stage of gestation.it is imperative to admit your wife to give a course of betamethasone for foetal lung ripening then plan for delivery along with nicu backup. Once delivered to rescan babies kidney depending on the obstruction plan surgery along with a pediatric surgeon. For more light can also take opinion from paediatricsurgeon ante natally.
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Suggest Treatment For PUJ Obstruction In Fetus During Pregnancy

Hi puj obstruction happens because of outflow tract obstruction down stream. Because your foetus is 29 weeks and there is damage to the kidney it is critical we intervene. Even though the one kidney can do in adult life we do not know the functionalty just now. The increasing dilatation perse is not a worry it could be superimposed hormonal effect but back pressure on the kidney is a concern.at the same time lung maturity is low at this stage of gestation.it is imperative to admit your wife to give a course of betamethasone for foetal lung ripening then plan for delivery along with nicu backup. Once delivered to rescan babies kidney depending on the obstruction plan surgery along with a pediatric surgeon. For more light can also take opinion from paediatricsurgeon ante natally.