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Duplicated ureter or duplex collecting system is a congenital condition in which the ureteric bud, the embryological origin of the ureter, splits (or arises twice), resulting in two ureters draining a single kidney. It is the most common renal abnormality, occurring in approximately 1% of the population. [1] [2]
Bladder outlet obstruction can be identified during routine prenatal ultrasonography as dilation of the fetal urinary tract [3] and decreased amniotic fluid levels. If dilation of the fetal urinary tract is suspected during pregnancy, an ultrasound of the infant's kidneys and bladder should be obtained after birth.
The signs and symptoms of hydronephrosis depend upon whether the obstruction is acute or chronic, partial or complete, unilateral or bilateral.Hydronephrosis that occurs acutely with sudden onset (as caused by a kidney stone) can cause intense pain in the flank area (between the hips and ribs) known as a renal colic.
Fetal urine production begins in early gestation and comprises the majority of the amniotic fluid in the second and third trimesters of pregnancy. The fetus continuously swallows amniotic fluid, which is reabsorbed by the gastrointestinal tract and then reintroduced into the amniotic cavity by the kidneys via urination.
Multicystic dysplastic kidney (MCDK) is a condition that results from the malformation of the kidney during fetal development. The kidney consists of irregular cysts of varying sizes. Multicystic dysplastic kidney is a common type of renal cystic disease, and it is a cause of an abdominal mass in infants. [5]
The fetal skeleton requires approximately 30 grams of calcium by the end of pregnancy. [5] The mother's body adapts by increasing parathyroid hormone , leading to an increase in calcium uptake within the gut as well as increased calcium reabsorption by the kidneys.
Most children with vesicoureteral reflux are asymptomatic. Vesicoureteral reflux may be diagnosed as a result of further evaluation of dilation of the kidney or ureters draining urine from the kidney while in utero as well as when a sibling has VUR (though routine testing in either circumstance is controversial).
The development of the kidney proceeds through a series of successive phases, each marked by the development of a more advanced kidney: the archinephros, pronephros, mesonephros, and metanephros. [1] The pronephros is the most immature form of kidney, while the metanephros is most developed. The metanephros persists as the definitive adult kidney.