Hydronephrosis of 3 degree in newborns. Hydronephrosis of the kidneys in newborns - than dangerous and how to treat him

Complete collection and description: kidney hydronephrosis treatment in infants and other information for the treatment of man.

Hydronephrosis is called a disease in which the blockage of the ureter with a concrete, a tumor, a blood clots, or a metering of urine from the kidneys as a result of the development of urinary organs is disturbed.

Newborn is usually found in congenital pathology, which affects one of the kidneys (most often left). But there is also a bilateral defeat (in 11% of cases from the total number of detected disease). With this option, urgent surgery must be applied, otherwise the death of the baby may come as a result of the development of insufficiency. The combination of the expansion of the renal pelvis and the ureter is called the yereterohydronphrosis.

With such a diagnosis, as hydronephrosis in newborns, treatment is carried out mainly by the operational way, all conservative techniques are applied only for some facilitation of the state and in order to prepare for surgical interference. Medicines and in the postoperative period are used to reduce the likelihood of the development of complications.

Boys this disease develops more often than girls three times. The reason for the development of pathology is an unhealthy lifestyle, which leads a future mother during pregnancy, as well as suffering from the disease during this period.

Manifestations of hydronephrosis

This ailment is dangerous in that it begins to manifest itself a cup of only in the third stage. And the timely detection of hydronephrosis in the newborn completely lies on the parents of the baby. Attention should be paid if the child becomes a capricious, there is a bad thing, he has a dream. When developing pain in the tummy, it can be stuck with legs and pull them up.

It is especially important to pay attention to the quality and state of urine. Immediately go to the doctor, if blood discharge appears on the diapers.

The main sign of this disease is to increase the kidney, which is easy to try with a bimanual palpator study, or when the ultrasound is passed. A strong increase in the kidneys in the kid can be seen by increased stomach. The addition of infectious complication, which often accompanies hydronephrosis, is observed an increase in temperature. In the urine, the increased content of leukocytes is detected.

Causes

In newborns, hydronephrosis can develop for several reasons:

1. Connection of the location of the junction in the ureter.

1. The narrowing of the rear of the ureter in the bladder. In this case, not only hydronephrosis develops, but also the accumulation of fluid in the urethre (megaloureter).

1. Development of bubble-ureter reflux. In this condition, there is a return back of the bladder fluid in the ureter. Comes as a result of congenital underdevelopment or lack of valves that do not allow inverse urine outflows.

1. Unstructive hydronephrosis. There is such pathology rarely. With it, there is a violation of urine removal by the kidneys without visible mechanical obstacles.

1. Polycystic renal dysplasia.

1. The presence of the rear valve of the urethra.

1. Ureterocele.

1. Traumatic damage or tumor process.

Types of treatment depending on the degree of disease

The newborn baby is distinguished by three degrees of the disease:

1. The first degree is called PiilEctasia. It develops as a result of a minor impaired urine release from the kidney, while its functional abilities are fully saved. There may be some increase in cavities.

1. The second stage is called the hydrocalicosis. From the beginning of the first stage, several months usually passes. In the tubules and lochanks there is a significant cluster of the fluid, which presses on the parenchyma, and causes a violation of the kidney function.

1. Finishing, or the terminal third stage leads to irreversible changes in the renal parenchyma. The function of the organ is significantly changed, or stops completely

Indications for the operation

Hydronephrosis of the kidneys in newborns can pass himself. For example, pyelectasia is not an indication for the operation. In some cases, it is physiological, and can pass independently. Such a child should be registered with a doctor, and regularly undergoes surveys. The question of a radical solution to the problem can stand in the case when the first stage begins to progress, and passes into the second and third. These diseases are considered pathology, and require urgent measures.

Modern methods of treatment make it possible to provide substantial assistance with minimal postoperative complications. The following deviations may serve as readings:

• expansion of kidney cavities;

• the presence in the kidney of the concrections;

• significant narrowing of the ureter;

• tumor education in the field of lochank.

Laparoscopic intervention

The most gentle and modern method is laparoscopic plastic. It lies in the fact that a laparoscope is entered through small cuts in the form of a tube, at the end of which the screen is located. Such intervention can be performed at any stage of this disease, and regardless of the age of the patient. Its fulfillment is contraindicated only by a premature newborn, and if they have other malformations. The stay of the child after the operation in the hospital continues for one week.

It is very important that the baby necessarily after that has become registered with the urologist, whom he should visit with his parents no less than 3-4 times a year. For the prevention of complications, it takes soils for some time. The duration of such a course is up to two weeks, sometimes the doctor can extend it, if necessary. In addition, urine analysis should be given during the first year after the operation, twice a month.

The rehabilitation period can be lengthened depending on the presence of concomitant pathology, other diseases, and the degree of probability of the development of complications. After urine begins to freely enter the bladder, the kidney sizes become normal, and damaged tissues restore their structure and function. It is possible to determine the normalization of blood circulation on the periphery of the organ with dopplerography.

With this diagnosis, as kidney hydronephrosis in newborns, treatment with the help of a laparoscopic method sometimes gives some complications, among which the infection or the occurrence of bleeding is observed. It should be noted that the likelihood of their development when performing the operation in a newborn, somewhat higher than in an adult person.

In some cases, surgical treatment may offer even the birth of a child. However, such manipulation can lead to premature births, so a woman usually warns about the possibility of such an outcome of the operation.

The success of the operation depends on the degree of violation of the kidney function. The probability of disadvantaged outcome remains high if the treatment is carried out in a child whose age does not reach six months.

Diagnose the disease in the fetus can be in 14-20 weeks of its intrauterine development. The frequency of detection of prenatal hydronephrosis is one case per hundred pregnancies. The study proved that the frequency of occurrence of this pathology leaves about two percent, the prenatal disease suffer mainly boys. In this case, the operation is also possible. But this may end up with premature births, which is necessarily a doctor must inform the mother.

Often, such a state can be transient, and take place without a trace after childbirth, or some time after some time.

Forecast

Modern methods of operational intervention guarantee a high probability of recovery. Minimally invasive techniques do not require long-term stay in the hospital, contribute to minimizing the development of complications. The chances of successful cure are somewhat reduced in the presence of concomitant kidney diseases (for example, polycystic).

Such a serious alert as hydronephrosis is characteristic of the fact that due to the most different reasons, the outflow of liquid from the lobcan of the kidney and its cups is disturbed.

As a result of this vice, the strip system of this body expands, the pressure in the kidney increases, which ultimately can lead to a slowdown in blood circulation and even to the atrophy of the parenchyma itself. In other words, the kidney functions are broken, sometimes irreversibly.

This disease can be acquired or congenital, and sometimes doctors can diagnose hydronephrosis in the fetus. Unfortunately, today there are quite often the defects of the development of the urogenital system at the embryonic stage, including such as congenital hydronephrosis.

It is very important on time, that is, in the process of pregnancy, diagnose. Since if this pathology is already identified by intrauterine, born, the child may well recover and lead a normal full-fledged life.

According to statistical data, the kidney hydronephrosis in the fetus is detected in 5% of cases of this disease.

Interestingly, the boys suffer from this ailment much more often. And in a quarter of children, patients with hydronephrosis, bilateral defeat.

Causes of congenital pathology

The 4-month-old kidney embryo is almost the same as a newborn - there is an excretory system, and a parenchyma, and a locher, and cups. Liquid is already moving, the fetus several times a day will empty his bladder.

Congenital hydronephrosis has a born baby develops due to the damage arises on the intrauterine stage of vices of the genitourinary system. Most often, in one way or another, the intelligence of the ureter is blocked, so the excretory function is broken.

Mainly, pathology occurs for the following reasons:

• anomalous kidney development in the form of horseshoe;
• multi-storey (usually left kidney);
• the presence of an additional vessel in the kidney;
• invalid extension (location) of the ureter.

If we talk about the specific causes of hydronephrosis, then it happens as a result:

• narrowing of the internal lumen of the ureter;
• squeezing it outside the vessel, inflamed cloth or a tumor;
• urine traffic disorders due to reflux, the presence of stone or the presence of injury;
• the special pathological structure of the ureter mucosa.

Why it is developing during the pregnancy of those or other vices from the fetus, it is definitely not clarified. However, experts call the factors that can lead to a certain risk, among them:

• environmental pollution and other environmental problems;
• ionizing radiation;
• burdened heredity.

Thus, gynecologists are sent to the family's genetics, planning a new pregnancy, in which the baby has already been born before, to eliminate the different congenital pathologies of the future child.

Classification

Hydronephrosis in children are divided into congenital (it is called primary) and acquired (this is the so-called secondary hydronephrosis). Naturally, the fetal can only be the first type.

Deal may be one-sided, such is found in most cases and affects either right or left kidney; And there are also cases of bilateral hydronephrosis, when changes affect both organs. This is diagnosed about 5% or 9% of all cases of this ailment.

Congenital hydronephrosis, however, as purchased, flows in three stages (degrees):

1. The first (pyelectasia). Urine presses on the kidney cavity, accumulating due to the disturbance of the outflow. As a result, the organ is slightly stretched, becomes more, but continues to function normally.
2. Second (hydroxide). This stage begins a few months later. Urine is copied in the channels of Parenhim, presses on it, disturbing the functioning of one or both kidneys. The organ is increased, the walls of it are thinned.
3. Third (terminal). There is no irreversible atrophy of the Parenhima itself. The kidney is very big, like a lochcan with cups, the organ stops functioning. A child with such a problem may lose the kidney at all.

Manifestations of hydronephrosis in the fetus

As a rule, hydronephrosis even in newborns and even more so the fetus can be identified only in the process of special diagnosis. For a pregnant woman, it is not to determine that the child may suffer from a similar illness. However, sometimes hydronephrosis leads to the lowland, and the woman is experiencing pain when the child is moving.

But the fact that the disease has no clinical signs, does not mean that it can not be paid to it. Due to hydronephrosis, other disorders in the development of the embryo may occur.

For example, it is badly supplied by the blood of the placenta, the hypoxia of the fetus comes, the child appears on the light weakened, with numerous dysfunctions, including respiratory.

There is also a risk of attaching an infection yet intrauterine. That is why women awaiting a child constantly watch the doctor, conducting planned surveys, including ultrasound.

Diagnosis of intrauterine

Usually, a pregnant woman passes in the process of having a child, three screenings - in every trimester one ultrasound. True, if there are suspected vice, the doctor may appoint additional surveys.

Already from the 16th week, the embryo starts working kidneys, so on the second ultrasound (which is carried out in the period from the 18th to the 20th week inclusive) the doctor checks whether the embryo has congenital kidney pathologies, as well as a bladder and ureterals. If only the presence of fluid is visible on screening, but neither the cup nor the pelvis has increased, such a deviation is not considered hydronephrosis.

Also, the diagnosis is not raised if the lochanks increased only by 5-8 millimeters. But when the expansion is more, we can talk about hydronephrosis. Most often, the fetus is one-sided.

Such cases are possible and such when a child in the womb is already a heavy and neglected stage of hydronephrosis. In this case, when conducting sonography, it can be seen that the kidney tissues are significantly fed, which further leads to renal failure.

Treatment of embryo

The tactics of the doctor who discovered the hydronephrosis fetus is based on the fact that a pregnant woman examines very often, and in most cases even hospitalized. However, the treatment of illness in the yet born baby conservative methods is not conducted.

In the most extreme case, an operation can be assigned. Usually it goes when there is a serious risk that the kidney will break. However, such intervention is fraught with premature births.

Frequent practice with such pathology - a catheter is put in the bladder of the fetus to carry out the urine outflow from his kidneys. This procedure helps to avoid the appearance of various complications.

If a pregnant woman has come to an experienced doctor, which conducts competent treatment, the forecast in the hydronephrosis of the kidney of her child is quite favorable.

Hydronephrosis in newborns

Features of this disease in babies are that it can develop differently. To date, there is still no accurate method that allows the doctors to make a reliable forecast. Therefore, the urologist, as a rule, never assigns the operation at once, even if hydronephrosis put a child in the intrauterine stage.

The baby is watching, look at the dynamics. Sometimes the urinary system can develop fabrics and organs - to divert pathology - to disappear by themselves. It happens that due to an unstable water exchange at this age, the work of the kidneys changes, the size of the pelvis comes back to normal after 3-4 weeks after birth.

On the other hand, literally in a couple of months there may be a serious deterioration, so that with surgery can be late. Therefore, it is so important to constantly observe the course of kidney hydronephrosis in newborns.

In most cases, pathology is due to congenital deviations and anatomical features of both external and internal features. Internal reasons include, for example, congenital underdevelopment of the lumen of the ureter, leading to its narrowing.

The external reason may be the formation of an additional vessel, which squeezes the ureter, in a compartment with an abnormal disorder of the latter from the pelvis.

Symptoms

Piilyectasia (Expansion of the Kidney Lohanca) is one of the main symptoms that is detected by ultrasound diagnostics. In addition, hydronephrosis can be manifested by hematuria (blood in the urine) or difficulty urination, sharp pain in the abdomen, an increase in temperature, concomitant infections of the genitourinary system, as well as the presence of impressive size in the abdominal cavity.

Diagnostics in children and babies

Hydronephrosis in newborns, he was revealed earlier or after the child appears to the light, in any case requires a number of studies. Unfortunately, the children of this age are not yet able to tell about what kind of symptoms they feel. Older child can complain about the new pain in the side, nausea; Baby just sometimes becomes extremely restless.

That is why besides standard palpation, as well as urine and blood tests, which will show the presence of inflammation, blood in the urine or other hidden signs of complications, the diagnosis is also made on the basis of:

1. Ultrasound. The specialist looks at the bladder and kidneys - in the filled form and after urination. Screening allows you to identify the pathology of the parenchyma, the obstruction of the jelly and the ureter. If the results cause doubts, a diuretic study is used in the study, the patient is given to drink water in large quantities.
2. Excretory Urography. In vein, the newborn is introduced by contrast, and then observe how this substance is displayed. This is concluded about the ability of the kidneys and the entire system to filter, about the degree of obstruction.
3. Computer tomography and MRI. Both of these studies in varying degrees allow you to see a three-dimensional image of all urinary structures and draw conclusions about whether there are hydronephrosis in newborns, and if so, in which stage and degree. If they are made to a breast child, then only under anesthesia.
4. NEFROMYCINTIGRAGY. This study is carried out using radioisotopes. In the course of such a procedure, the specialist assesses how the kidneys work, how violated the outflow of the fluid.
5. Miking cystography. This study is done if there is reason to suspect the presence of bubble-ureteral reflux (urine cast), or there is simply a bad outflow of the bladder fluid. The child also introduces contrast, but not to Vienna, but in the urethra. The bladder is filled, and when urination occurs, the doctor makes x-ray. It can be seen in the picture if the contrast is returned to the ureters.

Treatment

It depends on the stage of the disease. If the child's hydronephrosis is still a first degree, then the conservative therapy is carried out. It is primarily in the stimulation of fluid outflow.

In addition, it is necessary symptomatic treatment. So, in the case of infection, antibiotics are prescribed, anti-inflammatory agents. If necessary - preparations that reduce pressure and removing the edema of ureters.

As already mentioned, it is often a paramount itself, but in order not to miss its progression, children regularly conduct an ultrasound. The kids of age until 3 years - once every 3 or 6 months, older patients - once a year.

Both positive and negative dynamics can be observed at the second and third degree of the disease. Screening in this case is carried out every 2-3 months. If the state of the body deteriorates, and as the laughter is observed, it increases and expands - the surgical intervention is shown.

Indications for the operation

Heavier stages of hydronephrosis - starting with the second - by themselves, do not refer to surgical intervention. The operation is necessary if the child has expanded and the narrowing of the ureter, and in its sealer, also found in the child.

Fortunately, to nephrectomy - kidney removal - you have to resort only in the most difficult cases. They arise quite rarely, since urologists observe the child and do not allow hydronephrosis sharply progress.

The most common type of operation is pyeloplasty. It is carried out by different methods, the most effective of them is the way of Heins-Andersen. It lies in the fact that in the process of intervention, the narrowing portion of the ureter is excised, and they simultaneously form a normal connection to it with a loyalty.

The zone of the new compound is set to the catheter with a drainage tube derived from the outside, or a thin stent with the inner terminal of the fluid. In the first case, a small patient after the operation is in the hospital on average three weeks. In the second case - no more than 9 days.

Install the catheter or the stent - solves the surgeon, depending on the situation, degree of defeat and other factors.

It is believed that pyeloplasty is quite effective. It leads to significant improvements in 92-95% of all cases of its conduct. Typically, the function of the patient's kidney is restored after six months after pyeloplasty.

• Date: 17-02-2015
• Rating: 11.

• The emergence of the disease
• Stages of development of hydronephrosis
• Symptoms of disease and diagnostic methods
• Medical events

Kidney hydronephrosis is a rather unpleasant disease that prevents the derivation of urine from a collective kidney system. This entails severe consequences, including violation of the proper functioning of these bodies. This disease covers all age categories of the population. It is subject to both the right and left kidney.

The emergence of the disease

A newborn, such a disease is most often caused in innocent, and not acquired factors.

The main causes of pathology are the main reasons:

• the wrong position of the ureter;
• dyskinesia urinary tract;
• the incorrect location of the arteries in the kidneys, which is why they are put on the ureter;
• the ureter is incorrectly departed from the pelvis;
• the existence of an additional vessel, which presses the ureter;
• congenital narrow ureter in a child due to the underdevelopment of the lumen.

I would like to note the fact that the latter of the above reasons in medical practice meets much more often than others.

Hydronephrosis of the kidneys is diagnosed in 10% of newborns. This disease is considered congenital, it affects either one or two kidneys at one time and makes it difficult for urine permeability. The work of the cups and lochanks is disturbed, in the place where urine accumulates for subsequent outflows on the ureters. Hydronephrosis disrupts the work of this system, leading to the difficulties of urinary. As the disease develops, the kidney increases, parenchyma is thinned, functions are disturbed.

Classification

Hydronephrosis according to the degree of complexity is divided into three stages:

1. The first is the easiest. It is aimed at strengthening urine outflow from the human body. Treatment at this stage passes easily and practically always gives a positive result.
2. In the second stage, the work of an extended kidney is disturbed. Permanent stupid pain appears. The number of urine-derived from the body decreases. Punchiness may appear in the lumbar region. Often there is an increase in pressure. Breasts may have an increase in concern or drowsiness. The temperature rises and keeps high a long time. This stage is considered border and thanks to a timely prescribed treatment can go to the first. And the subsequent person fully recovers. But the transition to the third stage of the disease is possible.
3. The third stage is most dangerous. In such cases, the process of increasing the kidneys in size is underway. Reduced kidney activities (or two). Perhaps generally stopping her livelihoods. An atrophied parenchyma may also be. In these cases, operational intervention is necessary.

Symptoms

The hydronephrosis of the kidneys in newborns manifests itself:

• Children's crying;
• Almost always the bloating of the tummy;
• The child becomes sluggish;
• Refuses meals;
• Stops responding to toys and while sleeping a lot;
• Blood impurities in the urine of the child;
• It is possible to increase the temperature in the infection in the body.

Also, the baby is trying to hunt, nervously nervous, crying. It becomes difficult to calm down. With a bad removal of urine from the body, spasmodic pain appear.

Diagnostics

To detect hydronephrosis, women during pregnancy are obliged to undergo surveys. Even, being in the womb of the mother, the baby at the wrong development occurs deviations in the normal operation of the urinary system. It is better to reveal in the initial stages. The survey can be carried out on the 14th week. Usually, the doctor appoints this procedure in the period from the fifteenth to the twentieth week.

• The newborn baby examines the doctor, by palpation, it can identify the presence of hydronephrosis. After delivery, the ultrasonic examination is carried out (it is done on the third day).
• For a complete picture of the disease, the doctor may assign an ultrasound or cystura technogram. It helps to identify the cause of the disease.
• With the right side pain diagnose hydronephrosis of the right kidney. And with painful sensations from the left side - hydronephrosis of the left kidney. With pains on both sides, the overall hydronephrosis of the kidneys will be recorded.

Apply the following types of surveys:

• Ultrasound examination is an initial study of the state of the kidneys and their work;
• Analyzes are a general measure with a variety of diseases;
• Cystography - check the condition of the bladder and ureter;
• Computer tomography is the most perfect method of diagnosing the disease recently. It gives a more complete picture of the state of the kidneys in a newborn baby. And is absolutely safe in use;
• Nephrocintigraphy - will allow you to study the depth of the kidney change.

Treatment

Depending on which stage is hydronephrosis of the kidneys, and what causes it caused, the doctor appoints treatment to the newborn baby. This is not the problem that can be solved by waiting or folk remedies. Many mothers, without understanding what hydronephrosis is and to which consequences can cause a disease, they mistakenly believe that they can do without appeal to a specialist, thereby worsening the state of the child and bringing to the acute stage of the disease.

Treatment methods:

• If with the help of an ultrasound of a woman during pregnancy diagnosed hydronephrosis in the fetus, then most often doctors occupy an expectant position, since in 70% of the case most of the manifestations of the disease goes by itself. But even in this case, after birth, the child under 3 years should be observed from doctors 2-4 times a year and to undergo a survey;
• Drug treatment methods are peculiar to the disease at the first and second stages. Medicines, tablets, antibiotics - all of them are aimed at stimulating urine outflows. It is mostly enough to stop the progressive disease and cure it. The duration of therapy can sometimes take several months. The term of treatment depends on the state of the kidneys and the effectiveness of the prescribed drugs.
• If the kidney state is rapidly deteriorating, the treatment does not help, then go to the cardinal measures to carry out the operation.

Operation

Operational intervention is necessary at the third and fourth degree of hydronephrosis, while there is the possibility of saving the kidney. Modern methods of surgical treatment are more sparing. No big cuts. There is a point intervention in the body. Most often, children operate, applying pyeloplasty. Its essence is that instead of the too narrow junction of the magnifier and the ureter, the doctor forms a new, wider. This method is very effective and in more than 90% of cases gives a positive result. The state of the kidney is significantly improved, it begins to perform their functions and work as a full healthy organ.

If it is necessary to put the catheter with a drainage tube, then the child will spend at least three weeks in the ward. If the child is restored well, and it is enough to establish only the inner drainage stent, then in this case, after a week they write out. Extract a stent using special equipment only after 2-3 months after the doctor decides that the functionality of the kidney is completely restored.

Video on the topic 🎞

Hydronephrosis - renal pathology, which is often diagnosed in newborns. The disease can cause severe complications, and in the launched state, lead to the termination of the functioning of the organ. However, with timely diagnosis of the disease, modern treatment methods are able to eliminate the problem and return a full-fledged child.

What is the hydronephrosis of the kidneys in newborns

An important part of the kidney is a cup and a husk system, which is intended for accumulation and temporary storage of urine. From the cups urine enters the lochcan, then it is derived from the kidney through the ureter.

Urine accumulates in the birth of cups and pelvis, and after it is derived from the organ through the ureter

If the passability of the ureter is disturbed, it is formed in the kidney stagnation of urins. Most often, "blocking" is observed in a loan-urete segment.

The obstruction of the gluing ureteral segment leads to the development of hydronephrosis

In the chronic form of this process, hydronephrosis of the kidney is developing, which is characterized by the following changes in the organ:

• an increase in the size of the cup-lowering system, and hence the growth of the parameters of the kidney itself;
• atrophy of Parenhim (fabric filling the body);
• decrease in the excretory ability of the kidney;
• violation of blood supply to the organ.

Hydronphrosis is also dangerous in that the urine accumulated in the kidney is a favorable environment for the reproduction of pathogenic bacteria. As a result, inflammatory processes can develop in the kidney.

The medical term "hydronephrosis" has synonyms:

• kidney molding;
• uronhephrosis;
• hydronephritical transformation.

Types of disease

Depending on the formation of hydronephrosis, it happens:

• congenital. It is formed during the period of internal human development. The disease in boys develops three times more often than girls;
• acquired. Appears after birth.

Newborn children can only be diagnosed in congenital hydronephrosis.

Depending on the number of damaged kidneys, hydronephrosis is divided into such types:

• monotonia;
• bilateral.

Most often, newborn is diagnosed with unilateral hydronephrosis, bilateral pathology - rarity.

Degree of pathology

There are three degrees of disease development:

1. In the initial phase, an increhensively increases a cup-making system. The excretory function of the kidney remains unchanged. In the parenchyma, pathological processes are not fixed.
2. With a second degree, the kidney parameters increase by 20%, itching the walls of the pelvis, the daily domez decreases by 30%, there is damage to the panechim.
3. The terminal stage of hydronephrosis is characterized by an increase in the size of the kidney 2 times or more, the excretory ability of the kidney is reduced by 80%, the parenchyma completely disappears.

Depending on the size of the pelvis and the excretory ability of the kidneys, three stages of hydronephrosis are isolated

Video: hydronephrosis

Causes of illness

The hydronephrosis in the newborn is developing due to the abnormal structure of the urinary system organs. These deviations from the norm include:

The fetus can form a "unpreicious" structure of urinary tract for the following reasons:

• chromosomal disorders;
• infectious processes in the body in pregnant women;
• impact on the fruit of medicinal and chemicals;
• hypoxia (oxygen starvation) of the fetus;
• harmful habits in a woman during pregnancy: smoking, alcohol consumption.

Symptomatics

In hydronephrosis, the newborn may have the following signs:

• frequent joining;
• enlarged belly;
• the presence of blood in the urine;
• lack of appetite;
• slow weight set;
• periodic abdominal pain in which the child behaves restlessly;
• high body temperature;
• vomiting;
• diarrhea;
• edema on legs and handles;
• high blood pressure.

Symptoms of hydronephrosis in boys and girls are manifested the same.

Diagnostics

The fetal hydronephrosis can be diagnosed with ultrasound when a woman is located on the third trimester of pregnancy.

Ultrasound examination can reveal hydronephrosis in the fetus

The basis for the diagnosis of hydronephrosis in newborns - instrumental research methods:

• ultrasonic renal research. Provides information on the degree of increasing parameters of the cup-lowering system, reveals the anomalies of urinary tract;
• excretory urography - X-ray kidney with the use of a concessment substance that is introduced intravenously. By acting with blood flow in the urinary paths, the store substance enhances the visual visuals on the X-ray;
• computery Tomography kidney and ureterals are one of the most accurate diagnostic methods. During the study, layers of organs are obtained, which also identifies hidden pathological processes.

As well as laboratory research methods are used:

• general blood analysis. In hydronephrosis, an increase in leukocytes, a decreased level of hemoglobin, acceleration of ESO (erythrocyte sedimentation rate);
• blood biochemistry. Features of indicators in hydronephrosis: raising the level of creatinine and urea, decrease in the amount of calcium, potassium;
• general urine analysis. In the disease can detect a high level of protein, leukocytes;
• bacteriological Passev urine. It is carried out with inflammatory kidney processes. It helps to determine the causative agent of the disease, as well as the susceptibility of pathogenic microbes to those or other drugs. It is possible to choose an effective antibiotic.

Differential diagnosis

When diagnosing a diagnosis, a specialist differentiates (compares) hydronephrosis with the following diseases:

• polycystic kidney (formation in the organ of multiple benign tumors);
• kidney cancer;
• solitary (single) cyan kidney.

Treatment

The main tasks of treatment of hydronephrosis are:

• restoration of normal urine movement;
• elimination of the inflammatory process in the kidney.

Treatment of disease is predominantly surgical. The expectant tactic is possible only at the first degree of hydronephrosis.

Surgical intervention

Operational intervention is able to completely eliminate the cause of the disease. However, surgical treatment has contraindications:

• absolute.
  • violation of blood intake;
  • high body temperature;
  • acute inflammatory processes in the kidney;
  • heart failure;
  • prematurity;
• relative:
  • anemia (low hemoglobin in the blood);
  • diseases of the respiratory system;
  • indigestion.

Installation of nephrostomy

Before the operation in the kidney is installed nephrosta (drainage tube) to restore urine outflows. Currently, this method is most often practiced by the introduction of a kidney drainage:

1. Under the control of the ultrasound, the specialist carries into the area damaged kidneys.
2. A special rubber tube is introduced into the lochcan, through which Urina will go.
3. The outer edge of the tube is located outside the body and is joined in a special accumulator urination container.

How is surgical intervention

The surgical intervention in the restoration of the ureter can be carried out on various methods, but the method of Heins-Andersen is considered the most effective. Adjunation method:

• simplicity;
• low probability of recurrence of the disease.

Algorithm for the operation:

1. The narrowed part of the ureter is excised.
2. It is removed by the pathological part of the lobcker kidney.
3. The remaining parts of the locher and the ureter are stitched. Thus, a new gluttonous ureteral mouth is formed, according to which the movement of urins will occur.

Access to the operated area can be performed both open (using a sectional) and laparoscopic method. Currently, laparoscopic operations are increasingly used, which are less traumatic. In the abdominal wall, 3-4 punctures are produced through which mini-investments and an endoscope are introduced into the body cavity (a device equipped with a visible coupower).

Endoscope - Medical appliance equipped with video cameras

The entire process of operation is visible on the monitor screen to which the camcorder is connected. This ensures high accuracy of the operation.

Nephrectomy - Extreme Meas

If the kidney has completely lost the excretory ability or cannot eliminate the inflammatory process in the organ, nephrectomy (kidney removal) is performed. The operation is carried out as follows:

1. Fabrics are layered in front of the ribs.
2. A cut between the ureter and the kidney is performed.
3. On the ureter is superimposed.
4. The kidney is extracted from the body.

Recovery period

After the operation, the newborn dwells in the hospital for 1-2 weeks under the supervision of doctors. After this period, if postoperative complications were not found, the child is discharged from the hospital.

After that, the baby must be registered with the urologist, whose visiting should be 3-4 times a year.

Antibacterial therapy

Antibacterial therapy is applied in the following situations:

• in the presence of an inflammatory process in the kidneys;
• after surgery.

Newborn children with hydronephrosis can be assigned such antibiotics:

• Amoxicillin;
• Augmentin;
• Cefuroxime;
• Ceftriaxone.

Antibiotics are injected in an injection or infusion (with a dropper) method.

Diet nutrition

At hydronephrosis, a diet number 7 was recommended, created in the last century by the Soviet doctor M. I. Pevzer. Newborn children are on breastfeeding, so mammies need to adhere to dietary food. It should be excluded from the diet such products:

• salty;
• marinated;
• fat;
• fried;
• smoked.

Under the complete prohibition there are alcoholic and carbonated drinks.

• vegetables;
• fruit;
• low-fat varieties of fish and meat;
• vegetable soups;
• cereals;
• milk products with low fat content;
• green tea.

Prediction of treatment and possible complications

If the treatment of hydronephrosis in newborns is started in a timely manner, then the forecast is more often positive: the disease is completely successful to win.

In the launched state, congenital hydronephrosis leads to such sad consequences:

Prevention

To reduce the risk of hydronephrosis in the fetus, a woman during pregnancy should adhere to the following recommendations:

• competently use medicines. Before accepting any medicines to consult with the attending physician;
• do not smoke and not drink alcohol;
• in time heal all inflammatory processes in the body.

If your child is raised by the hydronephrosis, do not despair. Currently, this disease is not a sentence. With a competent approach to the disease, treatment will necessarily be successful.

Hydronephrosis is a kidney disease, characterized by the expansion of a cup-making system and a violation of urine outflow due to the atrophy of the organs themselves, which leads to a failure of their work. The disease occurs both in adults and in children, and the hydronephrosis in newborns may occur at the stage of intrauterine development during the pregnancy of the mother. Among children, pathology is more common in boys than girls. In addition, it is noticed that the left kidney is amazed in large cases than the right.

Causes

Hydronephrosis is congenital and acquired.

The acquired expansion of the CHLS (a cup-making kidney system) occurs mainly in adults because of various reasons, including urolithiasis. Newborn disease occurs due to:

• anomalies of the ureter development;
• reverse cast of urine from the bladder in the ureter;
• hereditary predisposition;
• mechanical obstacle to the outflow of urine.

The main factor in the occurrence of hydronephrosis in the child is the stenosis (narrowing) of the gluing ureteral segment. In most cases, this is the presence of an extension artery, which, due to its relative position, can squeeze the ureter and prevent urine outflow. Sometimes hydronephrosis occurs due to the irregular position of the ureter or anomaly of the development of renal vessels. The narrowing of the launchous ureteral segment can be congenital malformation. In addition, the disease arises due to the unfavorable course of pregnancy of his mother.

Classification

Breastfish hydronephrosis is classified by the number of affected organs: left, right kidney or double-sided.

Distinguish several stages of the disease:

1. Characterized by initial changes. The kidney function is not broken, the expansion of pyelok (pyelectation) is extremely insignificant.
2. Lohanks are greatly expanded, the work of the organs is broken.
3. Terminal. The kidney is increased in size, its fabric is atrophied, and the work is reduced by 70-80%.

Symptoms

In a breast child, hydronephrosis can not be manifested immediately, which makes it difficult for diagnosis. Usually, children become restless, blood appears in the urine in the form of small residences. If you touch their stomach, you can notice a rather strong voltage of the anterior abdominal wall.

Often hydronephrosis in newborns are detected only when infection is attached, which will be accompanied by signs of general intoxication: increased temperature, vomiting, lethargy and poor appetite. When suspicion of hydronephrosis, it is necessary to consult a doctor as soon as possible. The pediatrician will definitely diagnose and assign treatment if necessary.

Diagnostics

The hydronephrosis of the fetus is to be diagnosed during pregnancy, with the help of screening ultrasound research for 15-20 weeks. On this time it is possible to see all the organs and systems of the child and determine the deviations from the norm. Ultrasound is used to examine newborns. This is usually happening at the age of 1 month: a specialist notices the increase in the size of the right or left kidney, the expansion of the CHLS.

Another method of studying hydronephrosis in a child will be an excretory urography for comparing and evaluating the excretory function of the right and left kidneys. Computed tomography can be applied for diagnostics (with suspicion of urine reflux from the bladder).

The pediatrician can put congenital hydronephrosis with palpation. In this case, the doctor must determine the tumor-like renal education and, comparing the inspection data with the results of the survey (including the flow of pregnancy), to identify the disease.

Treatment

If the hydronephrosis of the fetus was diagnosed even during intrauterine development, then the woman is carefully examined, prescribed complex treatment and are observed over pregnancy. After childbirth, the child is once again inspected, since there are cases when the newborns did not observe hydronephrosis, but it was revealed on screening ultrasound during pregnancy.

If the expansion of the CHLS is still there, then the child carries out dynamic observation with the passage of the survey complex every 2-3 months. There is a possibility that up to the year the work and the state of the kidneys will come to normal and the treatment will not need . Nevertheless, it is not necessary to engage in self-medication or not pay attention to the disease, since only a doctor can judge this. Running hydronephrosis is fraught with complications and the need for constant dialysis in the future.

In some cases, conservative therapy may be required. Congenital hydronephrosis, accompanied by significant impairment of the kidney function, an increase in their size is subject to surgical treatment. Currently, laparoscopy is used for surgical intervention in newborns and children. Its advantage consists in low traumatic, low probability of developing postoperative complications and a short recovery period.

It should be understood that with a timely, adequate treatment of congenital hydronephrosis, it is possible to achieve a good result, the restoration of the size of the kidney and lochank, as well as their satisfactory work. After the course of treatment, the child must be under constant supervision of doctors, to control its condition.

The prevention of hydronephrosis in newborns can be considered a timely examination of the mother during pregnancy and the child in the first months of his life, and prevent the harmful effects of various factors on the fruit (alcohol, smoking).

• The emergence of the disease
• Stages of development of hydronephrosis
• Medical events

Kidney hydronephrosis is a rather unpleasant disease that prevents the derivation of urine from a collective kidney system. This entails severe consequences, including violation of the proper functioning of these bodies. This disease covers all age categories of the population. It is subject to both the right and left kidney.

A newborn, such a disease is most often caused in innocent, and not acquired factors.

The main causes of pathology are the main reasons:

• the wrong position of the ureter;
• dyskinesia urinary tract;
• the incorrect location of the arteries in the kidneys, which is why they are put on the ureter;
• the ureter is incorrectly departed from the pelvis;
• the existence of an additional vessel, which presses the ureter;
• congenital narrow ureter in a child due to the underdevelopment of the lumen.

I would like to note the fact that the latter of the above reasons in medical practice meets much more often than others.

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Stages of development of hydronephrosis

There are several stages of the development of hydronephrosis in newborns, which are moving into each other.

At the initial stage of the child, the kidney functions are preserved completely, but a small amount of urine in Lohanka is already beginning to accumulate, gradually stretching its walls.

When the second stage comes, the child has gradually decreases the functional activity of one of the kidneys, for example, right. It works for only 60%. In order for the body to work in the usual mode, the load on the second kidney (left) increases.

The third stage is the terminal (last). During this period, the right kidney is either working very poorly, either completely disconnected. For this reason, all work remains on the second kidney (left), but it is too long. As a result, acute renal failure is developing. If you do not treat the disease, then the kidney hydronephrosis will lead to the death of man.

The child should provide qualified medical care, and for this it is extremely necessary to identify a disease in time.

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Symptoms of disease and diagnostic methods

Usually, pathology proceeds asymptomatic. The first symptoms can manifest itself with the penetration of infection or during injury. At such moments there is observed:

• pain in the area of \u200b\u200bthe lumbar department, which occurs at any time of the day;
• kidney colic, accompanied by vomiting, nausea, diarrhea attacks;
• raising blood pressure;
• in the hypochondrium, a small tumor is trying;
• sometimes the body temperature can increase.

Diagnostation is carried out in the clinic. There are several techniques, with which an experienced doctor with a large probability will be able to diagnose hydronephrosis.

The main method in the diagnosis was to conduct an ultrasound. It is able to determine the pathological violation already at the fifteenth week of development of the fetus in the womb. The manifestation of hydronephrosis in newborns begins the expansion of the renal loch. If, after the birth of Lohanka did not decrease, it is necessary to carry out in-depth studies by the decision of the urologist.

It can direct the chest baby for additional procedures:

1. Ultrasound kidney and bladder. Conduct this procedure before and after urination. An experienced specialist is capable not only to identify the disease, but also to determine his stage. Sometimes the results of the ultrasound can be uncertain. In this case, ultrasound with water load and various diuretic drugs are carried out.
2. Miking cysturketrography. Make the kidney x-ray with the introduction of a contrast agent. They are carried out in cases where the doctor has suspicions on bubble-ureteral reflux or difficulty of urine outflow from the bladder.
3. Intravenous urography. It is carried out in order to establish the degree of obstruction. A contrast agent that will be visible on X-rays will be introduced into the children's body. This remedy will fall into a collecting system of kidneys to remove from the body.
4. Nephrocintigraphy. Survey of kidney with radioisotopes. It helps to estimate the function of the kidneys and a violation of urine outflow from the bladder.