How is a kidney ultrasound performed during pregnancy? Indications for ultrasound on the kidneys during pregnancy. Study of the paired organ of the fetus

Ultrasound of the kidneys during pregnancy is an effective examination of the mother during this period, which makes it possible to safely diagnose a large number of kidney diseases for the fetus. An ultrasound examination is carried out according to indications, it requires a woman to comply with the minimum preparation rules.

She allows timely detection and treatment of the pathology of this most important paired organ.

And this helps to avoid problems not only with one's health, but also to give health to a small life developing inside.

Why is it important to have a kidney ultrasound during pregnancy?

During pregnancy, the immune status of a woman changes: the defense system is deliberately suppressed so that it does not recognize the fetus as a foreign body. At the same time, protection against infection, including urinary tract infections, is also reduced.
Hormonal restructuring in a woman's body provokes, among other things, the relaxation of the sphincter muscles between the internal organs. This also applies to the sphincter between the urethra and bladder, as well as between the bladder and ureters. Because of this, the infection becomes easier to penetrate into the kidney in an ascending way.
The pregnant uterus presses on the bladder in the later stages, because of this, stagnation occurs, which also “helps” infection of the kidney.
The kidneys of a pregnant woman remove not only their waste substances and toxins, but also the waste products of the child, that is, they "work for two."
In addition, usually a woman "enters" pregnancy with a large number of chronic diseases, including cystitis, kidney stones, and others. This, along with circumstances that worsen the outflow of urine, contributes to the occurrence of kidney disease.

During the bearing of a child, the mother does not always feel pain in the lower back or other symptoms indicating a pathology of the kidneys; or she writes it all off as "the norm."

The "kidney" temperature of 37.1-37.3 degrees is generally attributed to the signs of an "interesting" period. Namely, intoxication and circulation in the mother's body of microbes and their own substances designed to fight them adversely affect the developing fetus.

In these cases, only regular urinalysis and kidney ultrasound during pregnancy can help in making a diagnosis and prescribing treatment.

When is it necessary to undergo an ultrasound examination of the kidneys?

change in urinalysis
lower back pain, especially if they are severe, radiate to the suprapubic region, perineum or thigh
pain or discomfort when urinating
if sand, small stones or other formations are visually determined in the urine
urine has changed color and / or smell (especially dangerous is the admixture of blood in the urine when it acquires the color of “meat slops”, becoming brown or reddish)
after a lumbar injury (along with a general urine test)
with chronic pyelonephritis or glomerulonephritis before pregnancy
if you notice that there is less urine, despite the normal body temperature, the absence of diarrhea and vomiting (with a normal drinking regimen).

Ultrasound helps to identify such diseases of the kidneys and urinary system:

cysts.
Tumors.
Abscesses.
Hydronephrosis (dilation of the pelvis).
Pyohydronephrosis (a purulent cavity in the kidney tissue plus an expansion of its pelvic system) as a complication of pyelonephritis, despite the fact that acute pyelonephritis is not always visible on ultrasound.
Violation of the patency of the urinary tract.
Stones or sand in the kidneys, their type, localization.
Anomalies in the development of the kidney.
Bladder diverticula.

With the help of ultrasound, you can only see a change in the structure of the kidneys due to some kind of pathology.

The main diagnosis of kidney disease belongs to various urine tests:

1. Urinalysis

It helps to suspect a general pathology of the kidneys and urinary tract without specifying exactly where the "problem" is. So, the presence of at least one of the criteria:

more than 5 leukocytes in the urine,
specific gravity digits less than 1008 or more than 1020,
a large amount of epithelium (especially if there is the word "renal"),
more than 3 erythrocytes (or there is at least one “leached”),
the appearance of protein in the urine
the presence of any cylinders

says that you need to contact a nephrologist, urologist or therapist, and continue to examine the kidneys.

2. Urinalysis according to Zimnitsky

The test is carried out first of all when the specific gravity in the general analysis of urine is more or less than the norm. It gives an idea of the concentration function of the kidneys during the day.

In this case, every 3 hours, urine is collected in a new container, then all these 8 jars are brought for analysis. On the direction you need to indicate how much liquid you drank that day, your weight and height.

3. Analysis according to Nechiporenko

It is prescribed when more erythrocytes, leukocytes or epithelium have appeared in the general analysis than is permissible. The method helps to accurately calculate their number, on the basis of which differential diagnosis of diseases of the urinary system is carried out.

A specialist talks about the features of ultrasound during pregnancy.

4. Study of urine for microflora

This analysis makes it possible to find out which bacterium caused inflammation of the kidneys or urinary tract, which antibiotics can be used to fight it.

Preparation for ultrasound diagnosis of the kidneys during pregnancy

1. Three days before the ultrasound, we exclude from the diet those foods that cause increased formation of gases in the intestines:

carbonated drinks
dairy
legumes
sauerkraut
black bread
sweets, muffins.

2. An hour before the study, you need to drink 2-3 glasses of plain water without gas, then try not to urinate. If not, go to the toilet, then drink another glass of water. If the pregnancy is more than 12 weeks, the filling of the bladder should be asked directly from the doctor who will conduct the study, as this is usually not required.

How is a kidney ultrasound performed during pregnancy?

There is nothing complicated, dangerous or painful in this study.

You undress to the waist or simply lift your clothes so that you have access to the abdomen to the pubic area, as well as to the lower back.
A special gel is applied to the skin, along which the sensor will move.
An ultrasound of the kidneys of a developing child is also done.

Interpretation of study results

The kidneys are bean-shaped, located near the 12th thoracic, first and second lumbar vertebrae. The thickness of the kidney in a woman is about 5 cm, the thickness of the kidney parenchyma is up to 25 mm (may be less, depending on age). The width of the organ is about 60 mm, and the length varies from 10 to 12 cm.

The renal parenchyma is homogeneous, hypoechoic in the norm. The echo density of the renal pyramids is lower than that of the parenchyma. The contour of the kidney is even, clear. The mobility of the kidney during respiratory movements is about 2-3 cm.

Normally, there is no “calculosis”, “echotones”, that is, stones. There should be no "volumetric formations", which may turn out to be an abscess, a tumor, or a cyst.

Information about the kidneys of a developing child

An ultrasound of the fetal kidneys is done during a routine ultrasound during pregnancy. This does not require any special preparation: you come as you would for a regular – scheduled or unscheduled – examination.

Up to 12 weeks, if ultrasound is performed through the anterior wall of the abdomen, then the bladder needs to be filled, but if transvaginal diagnosis is performed, then nothing needs to be done as preparation.

The kidneys of the fetus are formed already at the 7th week of pregnancy. For a long time, they do not look like an adult, going through several stages in their development. At first, these are several separate lobules connected by a common ureter.

In this video, the doctor talked about popular misconceptions related to childbirth.

In the second trimester, the lobules merge, their common cortex becomes thicker. This structure persists even during the first few years of life. Urine begins to form from 11 weeks.

You can see the kidneys from 9-13 weeks with the help of a transvaginal examination. Abdominal ultrasound allows you to visualize the kidneys from 14 weeks. At 16-18 weeks they should be clearly visible.

In the second and third trimester, about 85% of anomalies in the development of the kidneys are detected with the help of ultrasound. They arise due to:

an early stop in the development of the kidneys (kidneys): then one- or two-sided absence of the kidney is detected;
impaired development of the tubules of the kidney;
violations of the movement of the kidney from the pelvic cavity into the abdominal cavity: the kidneys are located either in the pelvic cavity, or grow together, forming a horseshoe-shaped or annular kidney;
decrease in the patency of the urinary tract: this is how the expansion of the kidney departments occurs - hydronephrosis.

Often, anomalies in the development of the kidneys are combined with other malformations, this is often associated with oligohydramnios, which develops before the 20th week for various reasons.

Expansion of the renal pelvis in the fetus

It may also be described by the word "hydronephrosis" in the study protocol. Such a diagnosis is made if the anterior-posterior size of the pelvis measured at 16-20 weeks is 8 mm or more. After the 20th week, this diagnosis is established if the same size is more than 10 mm. In this case, 4 mm is considered the norm.

Since the diagnosis is serious, already at 16-20 weeks pregnant women are selected into a special group, in which the size of the renal pelvis of the fetus is in the range of 5-8 mm (after 20 weeks, fruits with a pelvis size of 7-9 mm deserve attention). These women undergo several targeted additional ultrasound examinations.

Usually, if this size of the pelvis does not exceed 10 mm and the cups are not expanded, the child is born without any pathologies of the kidneys. If this size is 10-15 mm without expansion of the cups, then the probability that a child will be born with healthy kidneys is already about 50-62%.

Other pathology of the urinary system in the fetus

Vesicoureteral reflux, that is, the reflux of urine from the bladder into the ureters (against the course). This can already be seen on ultrasound during pregnancy. In the future, such a child is under the supervision of a pediatric urologist, if necessary, he undergoes an operation.
Dilated ureter (megaureter). It can have both a favorable prognosis and require surgical correction immediately after birth.
Doubling of the kidneys. It looks like hydronephrosis, which is present only in the upper parts of the organ.
Polycystic kidney disease. If it manifests itself in the prenatal period and affects a large area, this is a very dangerous condition.
multicystic dysplasia. It occurs due to the fact that at the level of the renal pelvis, the flow of urine stops due to various reasons. Such a kidney with multicystic disease does not function.

Ultrasound of this system of the body during pregnancy can be both paid and free. It is produced not in antenatal clinics, but on the basis of hospitals and polyclinics.

Paid ultrasound of the kidneys can be done in multidisciplinary clinics and specialized centers. Its cost will be about 800-1200 rubles. The price of ultrasound diagnosis of the fetal kidneys is included in the cost of examination during pregnancy (900-1700 rubles).

Thus, ultrasound of the kidneys during pregnancy is a very informative type of diagnosis that allows you to find out in time that a woman has kidney pathology. This will allow timely treatment, preventing the additional possibility of infection of the developing child.

Ultrasound of the kidneys during pregnancy is not included in the register of mandatory diagnostic procedures. Nevertheless, it is prescribed quite often, as it allows you to explore the state of the urinary system of a woman. Since it is in this period that the risk of exacerbation of diseases increases. This is due to the fact that during pregnancy, a woman's functional load on the kidneys increases.

How do the kidneys function during pregnancy?

Medical statistics claim that during the period of bearing a child, kidney diseases take second place after the pathologies of the heart and blood vessels. Since the kidneys are responsible for excreting the waste products of both the woman and the baby. Moreover, over a longer period, the load on the mother's body seriously increases. With an increase in the gestational age, the uterus grows, begins to take up a lot of space in the abdominal cavity. Because of this, there is an increase in pressure on the organs that are in the abdominal cavity.

The ureters, kidneys, bladder are no exception. In this connection, the risk of developing urinary stagnation, which is a suitable environment for many harmful microorganisms, increases. Also, hormonal changes, reduced immunity, and exacerbation of chronic diseases affect the decrease in kidney function. During pregnancy, there are many prerequisites for the occurrence of renal pathologies. Based on this, timely diagnosis is of great importance for women's and children's health.

When is an ultrasound indicated?

Many women are interested in the question of whether it is possible to do an ultrasound of the kidneys during pregnancy, whether it harms the body of a fragile baby. Ultrasonic waves do not have a negative effect on the body of a woman and a fetus. But pathologies of the kidneys adversely affect the health of the future mother and baby. In the absence of timely treatment, kidney diseases often lead to missed pregnancy, premature birth, impaired development of the baby.

In addition, kidney diseases at their initial stage proceed without pronounced symptoms. This seriously complicates their early diagnosis. Therefore, timely analysis is important. Since it is often for further examination that they serve as an indicator of the presence of multiple deviations.

Indications for ultrasound diagnosis of the kidneys are:

the presence of deviations in urine tests, the presence of protein, erythrocytes, pathogenic bacteria, leukocytes;
lower back pain that spreads to the thigh, perineum, suprapubic region;
pain, discomfort during urination;
altered appearance of urine. This may be the appearance of a smell, staining of urine in brown colors;
the presence of chronic kidney disease before pregnancy;
lower back injury;
increase in blood pressure;
the presence of edema.

Moreover, the listed clinical picture is often combined with each other.

Preparation

To obtain reliable results, preparation for the diagnosis is important. First of all, this is the observance of a special diet for 3 days, aimed at reducing flatulence. To reduce intestinal gas, a woman should refuse products such as:

legumes;
fresh vegetables;
juices;
cabbage;
tomatoes;
fresh bakery;
sweets;
carbonated drinks.

During the procedure, the doctor may ask you to roll over on your side, hold your breath

If there is a need, it is recommended to take activated charcoal, Espumizan. Immediately before the procedure, the bladder should be filled. To do this, one hour before the examination, take 1 liter of clean water. Many are interested in the question of how the survey is done. Ultrasound examination can be performed both in the supine position and standing. During the procedure, the doctor applies a gel to the diagnosed area and examines the kidneys using a sensor. The duration of the examination does not take more than 20 minutes.

Decryption

The result should be interpreted by a doctor who has experience working with pregnant women. Since the parameters of the kidneys in women who are expecting a child are somewhat different from the size of the organs of a non-pregnant woman. Normally, the expectant mother should have the following indicators:

the kidneys should be located in the retroperitoneal space at the level of the 2nd lumbar and 12th thoracic vertebrae. The location of the right kidney is slightly lower than the left;
kidney mobility should be limited. Moreover, it should be observed only in a vertical arrangement. The presence of increased mobility is a sign of pathology;
the normal size of the kidneys should be no more than 12 cm long, no more than 6 cm wide, and no more than 5 cm thick. These indicators are important because they indicate the presence of a number of diseases. For example, an enlarged organ speaks of inflammatory processes, neoplasms. Reduced - about chronic pathologies, dystrophy;
the thickness of the renal tissue should be within 2.5 cm with a homogeneous structure. Thickened renal tissue occurs with inflammation, reduced - pyelonephritis, diabetes mellitus, dystrophy;
the renal pelvis should be free without the presence of any inclusions that occur in KSD;
the structure of the fibrous capsule should be even.

After the examination, the woman is given a form with the results, according to which the condition of the urinary system is assessed. The following changes can be written on the results sheet:

microcalculosis, echogenic formation. This indicates the presence of stones;
heterogeneity of the echostructure, the presence of echo shadows - tumors;
hyperechogenicity, homogeneous formation - lipomas;
anechoic formation, homogeneous anechoic contents without the presence of an internal echo - cysts;
purulent cavities - pyelonephritis, abscess;
enlarged pelvis - blockage of the urinary tract.

If it is necessary to assess renal blood flow, Doppler ultrasound is performed. This type of diagnostic evaluates the volume and speed of blood flow. This indicator makes it possible to monitor the functionality of the kidneys. If during the diagnosis a decrease in blood flow is detected, then a version of congestion, cystic formation, and an inflammatory process is put forward. Increased blood flow velocity is characteristic of a malignant tumor.

The dimensions of the renal apparatus of the fetus are also subject to analysis.

Pathologies identified during the procedure

When examined by a doctor, the following diseases are detected. ICD, in which the formation of sand and stones occurs in the organs. This has a connection with the violation of metabolic processes. During the diagnosis, the number of stones, their type, size, shape are determined. Behind the stones, an oval shape and an echogenic structure are visualized. If the stones are of small size, then the presence of an acoustic shadow may not be determined. The presence of fast-growing stones affects the closed pelvicalyceal region and the coral-shaped form.

Pyelonephritis of various types. During the procedure, it is determined by the disturbed tissue structure, dilated pelvises. Cysts, represented by cavities filled with fluid. The presence of polycystic disease can lead to the development of kidney failure. During the procedure, the number of cysts, their size is determined. Vascular anomalies that cause impaired blood circulation, which leads to the formation of renal failure. This condition is determined using dopplerography.

Omission of the kidneys, which causes difficulty in passing urine, leads to pyelonephritis, hydronephrosis. Ultrasound determines the degree of omission. For pregnant women, a descent of up to 3 cm is acceptable. After childbirth, the kidney can take its usual location. Injuries to the kidneys can be combined with injury to other organs located in the retroperitoneal and abdominal region. Most often, this pathology is visualized by a hematoma with high echogenicity and fluid accumulation. When Doppler is connected, a rupture of soft tissues is determined.

Tumor processes and their nature. During the ultrasound examination, tumors are visualized as dense structures. Ultrasound of the kidneys is a modern method for determining renal pathologies, which can be used to diagnose a pregnant woman.

Ultrasound examination of the kidneys is an affordable and very informative method for diagnosing the condition of this organ. With its help, almost all diseases are detected. Since pathologies of the urinary system are quite common in women during the period of bearing a child, ultrasound of the kidneys during pregnancy is indicated to many. This study is not necessary, and it is prescribed according to indications in cases where there is reason to suspect the presence of kidney problems or dysfunction of the organ.

Is ultrasound harmful?

Of course, we are primarily interested in whether ultrasound of the kidneys during pregnancy is harmful. This diagnostic procedure is considered harmless to the body and can be repeated as needed. There is no official data on the effect of ultrasound on the fetus, but no cases of undesirable effects on the unborn child have yet been identified, and ultrasound has been used as a diagnostic procedure for more than a decade.

Thus, the answer to the question of whether it is possible to do an ultrasound scan for pregnant women will be positive. Especially when you consider the danger posed by kidney diseases that are not detected in time.

If the doctor has prescribed an ultrasound, then you should not refuse this procedure, as it will help to identify the pathology in the early stages, because often kidney diseases are asymptomatic for a long time.

When is an ultrasound of the kidneys needed?

The female body during childbearing works differently. In particular, the kidneys carry an additional load, and therefore are at risk, even if there were no problems in this area before pregnancy. Indications for the diagnosis of this organ can be considered from different angles:

pathology of the kidneys in history;
endocrine disorders;
unsatisfactory urinalysis;
patient complaints;
objective manifestations.

Complaints - indications for ultrasound

Pain in the back and in the abdomen.
Pain when urinating.
Too much or too little daily urine.
Change in color of urine.
Injuries to the abdomen or back.

Since the pathology of the organ and impaired renal function may not appear immediately, an important indicator of the health of the urinary system is a urinalysis. His pregnant women hand over each time before visiting the gynecologist leading the pregnancy. It is possible that it is the results of the analyzes that become the reason for the appointment of the study.

What to look for when analyzing urine

Bacteriuria.
The presence of protein in the urine.
The presence of leukocytes.
Hematuria.

The reason for an additional examination may be such manifestations of kidney problems as edema and increased blood pressure.
If these phenomena are persistent, then an ultrasound of the kidneys must be done.

How to prepare for the procedure

If necessary, the preparation for an ultrasound will be quite simple. Care must be taken to ensure that there is no pneumatosis of the intestine, that is, increased gas formation during the study. To prevent an undesirable condition, it is recommended not to eat legumes, any cabbage dishes, dairy products, rye bread for three days before the procedure, as they contribute to the development of flatulence. You may need to take carminatives, such as activated charcoal or dill decoction, Espumizan may be effective. With intestinal pneumatosis, it will not be possible to obtain data, and the procedure will have to be repeated.

The second condition that must be observed is a full bladder. Therefore, when preparing, you need to drink 3-4 glasses of liquid about an hour before the appointed time.

How is the procedure

The woman releases the area under study, that is, the area of \u200b\u200bthe abdomen, lower back and a little higher. There should be no jewelry on the body in order to obtain the most accurate data. Most often, the procedure is performed with the patient lying down. Depending on the specific situation, the placement of the fetus, the features of the anatomy of a woman, she can lie in any position, the specialist who performs the study determines it.

With the likelihood of nephroptosis, that is, the prolapse of the kidneys, it is imperative to examine the kidneys in the position of a woman standing.

To perform the study, a special apparatus is used that sends ultrasonic waves. Reflecting from the organs, they make up the "picture" that is displayed on the monitor.

To improve conductivity and contact with the skin, a special gel is applied to the part of the body to be examined, it also ensures that the sensor slides over the body.

For a patient, ultrasound of the kidneys during pregnancy is quite simple. She lies or stands in the office, the doctor runs a sensor over the area where the kidneys are located. An image of the organ is displayed on the screen and some results are displayed. The doctor takes the necessary measurements and makes notes. On the basis of his conclusion, a diagnosis is made. When the procedure is completed, the gel is wiped with a napkin.

What might be the results

With the help of ultrasound, several parameters are determined that give an idea of the location of the kidneys, their size, structure, mobility, as well as the presence of neoplasms or calculi. All these parameters are recorded in the conclusion, on the basis of which the doctor draws conclusions and makes a diagnosis. As a rule, the diagnosis is not made in the ultrasound room, the results of the study are only described here.

Possible conclusions of a specialist

The norm, that is, the absence of identified pathologies.
Nephroptosis is a deviation of the kidneys from the normal location.
Microcalculosis - sand or small stones.
Echogenic formations - stones larger than 5 mm.
Tumor or cystic formations.
Deviation from the normal size of the renal pelvis.
Anomaly in the structure of the organ.

Based on the results of the procedure, it is possible to identify such pathologies as hydronephrosis, pyelonephritis, nephrolithiasis (urolithiasis), visualize neoplasms in the organs of the urinary system. If any deviations are revealed, and there is a trouble in the analysis of urine, then the pregnant woman should definitely undergo additional examinations to clarify the diagnosis and determine the degree of impaired renal function.

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Indications for examination

It is worth noting that, if necessary, an ultrasound examination can be performed at any stage of pregnancy and with the required frequency, since it does not adversely affect either the fetus or the expectant mother. Indications for the appointment of ultrasound of the kidneys during pregnancy are:

The presence of complaints of persistent or recurrent pain in the lumbar region or lateral flanks of the abdomen, which may radiate to the perineum.
Pathological changes in the general analysis of urine (leukocyturia, proteinuria or erythrocyturia).
The appearance of peripheral edema, which is most pronounced in the morning.
Persistent increase in blood pressure numbers.
Symptoms of dysuria (pain and discomfort at the time of urination, frequent urination, etc.).
As a dynamic observation of the course of chronic kidney disease, which was established before pregnancy.
The presence of any endocrinopathy (toxic goiter, diabetes mellitus).

Stages of preparation

In some cases, in particular with an emergency ultrasound of the kidneys during pregnancy, preparation is not required. However, if the procedure is planned, it is advisable to prepare your body for a more accurate examination.

As a rule, 2-3 days before the study, a diet is prescribed to reduce the amount of gases in the intestinal tube, since excessive gas contamination creates artifacts and interferes with normal visualization of organs. To do this, a woman these days should not eat white bread, raw vegetables and some fruits (bananas, apples), bakery products, flour and legumes.
The final stage in preparation is the filling of the bladder. To do this, a woman begins to drink ordinary non-carbonated water 2-3 hours before the procedure. Basically 1-1.5 liters is enough.

Technique

The complex of kidney diagnostics also includes ultrasound of the bladder during pregnancy, and the examination itself is performed in the same way as usual. The pregnant woman is laid on the couch on her back or side, and the diagnostician sets the sensor of the apparatus in the projection of the kidneys.

The study is conducted polypositionally in order to cover all parts of the urinary system. The location of the kidneys and bladder, their shape, contours and echostructure are assessed. Further, measurements of the walls of the bladder, parenchyma and pelvis are necessarily performed, since the kidneys undergo some functional changes during pregnancy.

Data decryption

Diagnostics is aimed at identifying deviations from the norm, which can manifest themselves in the form of:

Acute pyelonephritis, in which the echocardiography of the kidneys practically does not differ from that in the norm. Occasionally, thickening of the walls of the pelvis can be detected, less often - cups, blurring of the contour of the kidney and swelling of the perirenal tissue in the sinus region.

Urolithiasis. In this case, hyperechoic round formations with an echo-negative path are found. The doctor must count them and indicate the localization.
Hydronephrosis, which occurs due to a violation of the normal passage of urine. But do not forget that during pregnancy, the pelvis of the kidneys slightly increase in size and reach 25-27 mm. This diagnosis is made on the basis of dilated calyxes, pelvises, and thinned parenchyma.
Chronic glomerulonephritis. When performing ultrasound of the kidneys during pregnancy, this disease is characterized by hyperechogenicity of the parenchyma and a decrease in the size of the kidneys.
Nephroptosis - descent of the kidney below the set limit. If such a pathology is detected, observation is carried out in dynamics with registration of the degree of omission.

Ultrasound examination of the kidneys in the fetus

Also, during a planned ultrasound scan in the second half of pregnancy, the condition of the kidneys of the unborn child is also assessed. The purpose of this study is to identify the expansion of the pelvis in the fetus.

The urinary system of the fetus is formed from the start of embryogenesis until the last weeks of pregnancy and is a complex multi-stage process. It all starts with the formation of pro-, meta- and mesonephroses, which gradually replace each other.

The development of the kidneys of the fetus can be divided into four stages:

From the 5th to the 15th week, the collecting ducts of the kidneys and their pelvis are formed.
At the 16th week, renal arcades appear (a special localization of nephrons, in which they bind to the ampullae of the tubules).
In the period from the 23rd to the 26th week of intrauterine development, each nephron joins the terminal sections of its collecting duct.
At the 33-36th week of embryogenesis, the growth and maturation of the interstitial component of the kidneys occurs.

Causes of pathology and tactics

In about 2-3% of cases, ultrasound reveals pyelectasis - an expansion of the pelvis of the kidney in the fetus, which may indicate both congenital hydronephrosis and polycystic kidney disease, megaureter and bladder ectopia.

The study is carried out by transabdominal ultrasound in the 2nd and 3rd trimesters of pregnancy. The doctor evaluates the number, structure and size of the kidneys in the child. Normally, they are represented by elliptical formations with a hyperechoic contour, which is due to the presence of perirenal tissue.

The size of the pelvis varies depending on the duration of pregnancy. So, up to 32 weeks, their normal width does not exceed 4 mm, after - they reach 8 mm. That is, it is possible to reliably speak of pyelectasis in the fetus when registering the width of the pelvis at 10 mm.

The main reasons for the expansion of the pelvis in the embryonic period:

Hydronephrosis is a violation of the passage of urine at the site of transition of the pelvic system to the ureter. In this case, the pelvis and calyces are dilated, and the part of the ureter below the obstruction is of normal size or somewhat narrowed.
Vesicoureteral reflux is characterized by abnormal reflux of urine from the bladder back into the ureters and up into the kidneys.
Megaureter - can flow both independently and against the background of reflux. There is an enlarged pelvis and ureter, which is significantly narrowed in the lower sections.
Ectopia is a pathological condition in which the ureter does not enter the bladder, but opens into the vagina in girls or flows into the urethra in boys.

After the birth of a child with pyelectasis, a thorough examination is performed on ultrasound, monitoring him in dynamics, repeated ultrasonography to determine the progression of the disease and, if necessary, to select treatment tactics.

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Why is it important to have a kidney test during pregnancy?

The growing fetus presses on the organs, and if the kidneys are problematic, they will definitely manifest themselves as painful sensations. The health of this organ can result in negative complications for the child and the mother herself. For this reason, ultrasound of the kidneys during pregnancy is considered the most optimal method, since it does not harm the baby.

When is an ultrasound of the kidneys done?

Being in a position, a woman has to take a large number of tests. Urine sampling is performed on the eve of the next appointment with the doctor. In a healthy person, there is no protein in the urine, and in the urine of a pregnant woman, its presence is allowed, but in small quantities. In this case, the norm is considered to be a value not exceeding 300 milligrams.

Pain symptoms in the lower abdomen and lumbar region, painful excretion of urine can serve as a prerequisite for the appointment of an examination.

The detection of dangerous microorganisms in the urine also signals a problem. They can cause pyelonephritis, which can provoke premature birth. The main symptom of such a problem is the leukocytes found in the analysis of the biological fluid.

Is ultrasound harmful during pregnancy?

Any expectant mother worries about whether the ultrasound examination is a danger to the health of her child and her own. Almost all experts believe that the wave vibrations of ultrasound do not harm the developing fetus. But there is also an opposite argument.

Some doctors claim that ultrasound can have a negative effect on the formation of the embryo, but there are no convincing arguments for such a judgment. Nowadays, any pregnant woman undergoes this method of examination at least three times for the entire period, and doctors have never recorded negative consequences.

The conducted experiments aimed at studying ultrasound and its influence proved that there is no danger in this. However, it should be noted that the tests carried out were sponsored by the manufacturers of the ultrasound machines. Based on this, American experts advise to prescribe such a study only on the basis of the strictest indications.

When performing a study of the kidneys, not much time passes than is necessary to study the fetus, and the specialists try to touch the uterine zone as little as possible. It turns out that harm to the embryo in this situation is excluded. But in time, the pathology detected will make it possible to exclude the likelihood of serious complications.

Ultrasound of the kidneys: preparation

Nothing special preparatory stage does not imply. But there are certain recommendations that should be taken into account.

The main obstacle when performing an ultrasound examination is a swollen abdomen from gas formation. So all actions must be aimed at preventing such an undesirable phenomenon.

It is necessary to follow a special diet for three to five days, from which food products that can enhance the phenomenon of flatulence are completely excluded. These include:

legumes;
bread;
cabbage;
dairy products.

On the day when the ultrasound is scheduled, you should drink a couple of glasses of water an hour before the examination so that the bladder is full. If the woman could not hold back the urine and went to the toilet, she will be asked to drink water again. What you can not eat, and what you can before the examination, you can find out from our material.

You should also remove all jewelry so that they cannot distort the ultrasound data.

How is the diagnosis of kidneys in pregnant women?

The woman should lie down on the couch. In cases where there is a suspicion of prolapse of a paired organ, an ultrasound examination is performed while standing. The principle of the procedure is the same as for ordinary patients:

Interpretation of study results

The paired organ is distinguished by bean-shaped forms, located in the region of the twelfth thoracic vertebra. The thickness of the walls reaches five centimeters, the parenchyma - up to 2.5 cm. It may be less - it depends on the age category. The width of the kidney reaches six centimeters, its length is 10 - 12 cm.

The parenchyma of the kidney is smooth, homogeneous, echogenicity is normal. The density of the pyramids is somewhat lower than the parenchyma. The renal contours are even, clear, the mobility of the organ at the time of breathing is two to three centimeters.

Study of the paired organ of the fetus

Everything happens as usual - the kidneys of the unborn child are examined simultaneously during the examination of the female body.

Until the twelfth week, if an ultrasound examination is performed through the anterior region of the abdomen, the fullness of the urea is implied. When performing transvaginal diagnosis, preparatory measures are not required.

The paired organ of the baby begins its formation at the seventh week of the gestation period. Initially, it does not look like an adult, development goes through several stages. Initially, the kidneys are represented by several separate lobes connected by the ureteral tubule.

In the second period of pregnancy, the lobules begin to merge, the bark thickens. This structure can be preserved even in the first years of life. The formation of biological fluid begins at the eleventh week.

It is possible to examine the kidneys at the ninth - thirteenth week, using the transvaginal method of research. At the fourteenth week, the paired organ is visualized abdominally and can soon be seen clearly.

In the second and third periods of pregnancy, with the help of such a study, up to eighty-five cases of kidney anomalies out of a hundred submitted for the study can be detected. This is facilitated by early stops in the formation of the paired organ, deviations in the displacement of the kidney from the pelvic area to the abdominal region. The kidneys may remain in place or even grow together in a ring or horseshoe shape.

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Features of ultrasound

Ultrasound examination of the kidneys (may also be called sonography) presents the organ and its vessels in white-gray color. A dense formation (for example, a stone) will be lighter, cavities with fluid (cysts) will be almost black. Ultrasound will allow you to see even the thinnest nine-millimeter ureters in the form of light walls. Thus, the doctor can determine:

the size of the organ, its structure - homogeneous or with inclusions;
stones - stones or sand;
possible tumors or cysts;
change in the lumen of the ureters;
change in the position of the kidneys, for example, omission;
various inflammations - of the kidney tissue itself or its vessels;
purulent lesions - abscesses.

Also, a special sensor of the ultrasound machine can assess the condition of the kidney vessels (their lumen, length, patency) and the speed of blood flow in them. This study is called dopplerography.

What is it for

In fact, after conducting this type of examination, it is possible to identify any pathological changes in the kidneys and genitourinary system and thereby prevent pregnancy complications at an early stage of development. Ideally, it would be necessary to prescribe it to every pregnant woman, since even in a previously healthy woman, pregnancy often contributes to the development of the following diseases:

Pyelonephritis is the most common infectious disease. The risk of its development increases with an increase in the term and occurs in the second half of pregnancy, when the load on the mother's body increases to the maximum.

The next most common pathology in pregnant women is urolithiasis. Its development is facilitated by an increase in the concentration of salts in the urine, impaired urination, various hormonal changes that regulate metabolic processes.

Hydronephrosis is also a frequent companion of pregnant women, since the growing fetus compresses the ureters and overstretching of the contents of the pelvis in the kidneys occurs due to a violation of the outflow of urine.

Glomerulonephritis is a particularly dangerous immunoinflammatory disease, primarily because of the developing consequences. Namely, the possibility of premature placental abruption, miscarriage, a violation of the blood coagulation system and severe manifestations of preeclampsia.

Also, kidney damage, which is manifested by a high protein content in the urine against a background of high blood pressure, can cause preeclampsia (aggravated variant of preeclampsia - late toxicosis of pregnancy). A woman who has had preeclampsia or eclampsia has an increased risk of developing it during her next pregnancy.

What should prompt an ultrasound of the kidneys

Your own observations and feelings:

Discomfort when urinating in the form of burning, itching, feeling of an incompletely emptied bladder.
Urine became an unusual color - brown, with an admixture of blood, the so-called color of "meat slops". There was a strong unpleasant odor.
Noticeable sand or pebbles come out with urine.
Against the background of elevated temperature, pain appeared in the lower abdomen or in the lower back, back.
The blood pressure rises.
There was swelling.
You suspect that you may have injured your lower back or abdomen.

Medical indications:

In the blood and urine tests, there are signs of inflammation, protein.
Hormonal changes, exacerbations of diseases of the endocrine system.
The presence of chronic diseases of the genitourinary system - chronic pyelonephritis, glomerulonephritis, a tendency to form urates, etc.
Pathology of the development of the genitourinary system (for example, tortuous ureters).

Security measures

So, on one side of the scale - the undoubted benefits of ultrasound (as a very informative diagnostic method), but what about safety? Is it possible to do an ultrasound of the kidneys during pregnancy?

It is known that studies on ultrasonic exposure during the development of the embryo/fetus were carried out mainly on laboratory mice. However, the results show that the possibility of a hidden effect of ultrasound at diagnostic radiation power is extremely small. In addition, this research method has been widely used in world practice for many years, and there are no proven harmful effects.

But do not neglect some rules so as not to expose yourself and the child to unjustified risk:

Ultrasound should be used only when necessary, according to indications, because after all it cannot be considered 100% safe. Theoretically, if used carelessly, it is capable of causing thermal or mechanical damaging effects on the developing fetus.
Ultrasound should be performed only by medical personnel, observing the maximum duration of exposure and the minimum diagnostic power of the device.
The equipment must be in good technical condition.

Ultrasound procedure

Well, you have measured the theoretical risk and the importance of the diagnostic information, made a decision and you are preparing for the ultrasound of the kidneys. How is an ultrasound done?

Since it is theoretically possible to introduce an infection during a transvaginal procedure, and also due to the risk of miscarriage, the study is carried out only transabdominally (through the abdominal wall).

Abdominal examination

In this version of the study, the sensor will be located on the anterior abdominal wall of the patient. A special gel is applied to the skin, which improves contact with the sensor. Ultrasound of the kidneys during pregnancy is carried out from a position on the side so that you can see them behind the pregnant uterus. Also, the position of a woman on her stomach is not very convenient for her, and from the lower back, the kidneys may not be clearly visible due to the ribs and muscles.

Preparation. During an abdominal examination, you will need to follow a diet. It is possible to starve for 8 hours before the examination, for example, not to have breakfast after a night's rest. Also eliminate from the menu everything that causes you gas formation. As a rule, these are beans, peas, yeast, pastries, brown bread, sweets, carbonated drinks. This is necessary to reduce the amount of gases in the intestines, which can "blur" the picture of the study.

Ultrasound of the kidneys does not require filling the bladder. For its direct examination, it will be possible to drink 0.5–1 l of liquid without gas, and the doctor can also look at the bladder after emptying to determine residual urine.

After an X-ray examination using barium or another contrast agent, an ultrasound can be done in a few days.

results

Your kidneys are healthy if the description says they are bean-shaped; in location, the left is slightly higher than the right; when inhaling, they are displaced by 2-3 cm; have a clear, even contour, a hyperechoic capsule 1.5 mm thick, the size of the right and left differs by no more than 2 cm.

Having received the ultrasound report in your hands, you will definitely need to show it to the doctor who sent you. After all, any value, even, at first glance, negative, can be an indicator of your norm.

Ultrasound of the kidneys during pregnancy helps to identify and get rid of many serious pathologies in time. Carrying a child is a complex process. During this period, a large number of changes occur in the body of the expectant mother. They concern almost all organs and their systems, in particular - the urinary system. Every day the pressure on the kidneys increases. For this reason, it is necessary to constantly monitor their work. Is it possible to do an ultrasound of the kidneys during pregnancy? Will ultrasound harm the baby?

Why does a pregnant woman need to undergo such a diagnosis? This is a pretty good opportunity to follow the kidneys and how they perform their functions.

On a special screen, the doctor can see several important points:

the size of the kidneys and their structure;
the presence of stones or sand;
neoplasm or cyst;
narrowing or expansion of the ureters;
change in the localization of organs, in particular, prolapse;
inflammatory process;
abscesses.

With the help of an additional device - a doppler - the doctor will be able to assess the process of blood circulation.

Ultrasound of the kidneys and other organs during pregnancy makes it possible to see in advance some uncharacteristic symptoms and processes and prevent their further development.

There are four most dangerous conditions:

Pyelonephritis. It occurs more often than other diseases. It usually develops in the later stages, when the female body is subjected to excessive stress.
Urolithiasis disease. A consequence of an increase in the level of salts in the urine, changes in the hormonal background and disturbances in the excretion of urine.
Hydronephrosis. Due to impaired urination, the size of the renal pelvis increases.
Glomerulonephritis. This is the most serious disease that can provoke the development of severe complications. These are placental abruption, miscarriage, problems with blood clotting, etc.

Ignoring symptoms can lead to preeclampsia. This is one of the types of late toxicosis of pregnant women.

There are a number of indications for ultrasound of the kidneys during pregnancy:

Discomfort when going to the toilet. These include itching, burning, and a constant feeling of a full bladder.
Change in color and odor of urine. The presence of impurities.
Excretion in the urine of stones or sand.
Increased body temperature.
Pain in the lower abdomen, lower back or back.
High blood pressure.
Edema.
Suspicion of an injury to the lower back or abdomen.
Poor results of the general analysis of blood or urine. This is an increased level of leukocytes and the presence of protein.
Changes in the hormonal background.
Acute form of diseases of the endocrine system.
Chronic form of diseases of the genitourinary system. It can be pyelonephritis, glomerulonephritis, etc.
Congenital pathologies in the development of the genitourinary system. One example is tortuous ureters.

All of these conditions indicate the need for an ultrasound scan.

But it is worth remembering a few rules:

The procedure should be carried out exclusively by well-trained medical staff.
The equipment must be in good working order.
It is possible to conduct an ultrasound examination only if it is really necessary, since its effect on the child has not been thoroughly studied.

Before you go to the hospital, you need to prepare for the procedure.

Preparatory and "working" process

What does research preparation look like?

Three days before the ultrasound, you need to partially change your diet. Experts advise limiting the consumption of beans, peas, cabbage, carbonated drinks and sour-milk products.
If necessary, you should take some kind of carminative, for example, activated charcoal.
An hour before the examination, you must drink 250 ml of water. It will fill the bladder and allow you to get more accurate information.

How is a kidney ultrasound done?

A pregnant woman should undress to the waist. You should remove not only clothing, but also jewelry that can contribute to data distortion.
Lie on the couch on your side, stomach or back. If the doctor suspects kidney prolapse, the diagnosis will be performed while standing.
Throughout the procedure, you must remain still.
The doctor applies a special agent to the skin. It promotes better conductivity of ultrasonic waves.
At the end, the product is removed with napkins or towels.

Expectant mothers can be very worried about the condition of their child. They are concerned about the question: is ultrasound harmful to the baby? The official answer is no.

During the entire period of such procedures, not a single case of negative impact was found. At the same time, a serious illness not detected in time can lead to the development of complications in the development of the fetus, as well as endanger the life of both him and the woman.

So, during the period of bearing a child, ultrasound of the kidneys is done. This procedure will allow timely detection of pathological changes and take the necessary measures. And they, in turn, will protect the mother's and children's body from complications.

Ultrasound is an advanced diagnostic method and is absolutely safe for pregnant women (at least there is no evidence that ultrasound harms the development of the fetus), unlike x-rays (which are not recommended during pregnancy).

Ultrasound of the kidneys during pregnancy is not a mandatory procedure. It is prescribed only if there are symptoms of kidney disease. This diagnostic method allows you to painlessly determine their size and location, assess the condition of the kidneys and the processes occurring in them, and identify violations in the functioning of the kidneys.

kidney disease

Indications for an ultrasound of the kidneys include:

Kidney disease may be asymptomatic. In this case, bacteria (bacteriuria) can be detected in the urine, which indicates an infectious disease.

In the presence of any of these indications, it is necessary to conduct an ultrasound scan. After all, if the disease is detected in a timely manner and measures are taken to treat it, then a large number of complications can be avoided.

Ultrasound can detect kidney diseases such as:

urolithiasis disease;
pyelonephritis;
tumor.

The kidneys during pregnancy have a double load, because not only the woman, but also the fetus passes through the kidneys of the pregnant woman. That is, the kidneys work for two. The most common indicator for an ultrasound of the kidneys are laboratory tests.

Kidney pathology can be suspected if a general analysis in the urine reveals:

leukocytosis;
renal epithelium;
protein;
abnormal specific gravity of urine.

Pyelonephritis is diagnosed in 10% of pregnant women. Inflammation of the kidneys is provoked by a strong load that falls on the kidneys and hormonal changes that occur during gestation. If pyelonephritis began in a woman even before pregnancy, then it can worsen during pregnancy (at 20-30 weeks) and lead to spasm of the vessels that feed the placenta. This can lead to miscarriage.

Another dangerous disease is gestosis (late toxicosis) of pregnant women. At the same time, protein appears in the urine of a pregnant woman, blood pressure jumps, kidney failure develops, which can lead to kidney failure.

Preparing for an ultrasound

An obstacle to the ultrasound of the kidneys during pregnancy may be increased formation of gases in the intestines. In order to avoid this, you need to go on a diet three days before the ultrasound: exclude foods that promote gas formation from the diet (dairy products, brown bread, cabbage, legumes, carbonated drinks). Also, once a day, in order to prevent gas formation, you need to take drugs such as activated charcoal or espumesan.

Preparing for an ultrasound of the kidneys during pregnancy is that one hour before the study, you need to drink a couple of glasses of clean water and do not go to the toilet. If you can’t wait until the ultrasound, then after visiting the toilet you need to drink water again.

How is an ultrasound of the kidneys performed?

Conducting an ultrasound of the kidneys of a pregnant woman is not much different from performing an ultrasound of the kidneys of any other person.

The woman undresses to the waist and lies down on the couch, previously covered with a sheet or towel.
The doctor applies a special gel to her body, which improves the glide of the sensor over the skin and does not allow air to enter the gap between her and the sensor.
Next, the doctor drives the sensor along the lumbar region, abdomen and sides of the patient (in order to make it convenient to do this, the patient rolls over on the couch). Ultrasonic waves reflected from the internal organs of a woman are captured by a sensor, the signals are processed by a computer, and the information is displayed on the monitor screen. At the same time, the doctor takes measurements and records the results.
After the end of the study, the gel is wiped off the skin with napkins or towels.
The doctor prints out the results of the ultrasound and gives it to the patient.

Ultrasound results

After an ultrasound, the following conclusions are possible:

norm;
pyelonephritis;
hydronephrosis (violation of the outflow of urine, resulting in an expansion of the renal pelvis);
nephroptosis (omission of the kidney);
the presence of echogenic formations (kidney stones larger than 5 mm);
tumor formation;
cyst;
anomaly in the structure of the kidney;
pronounced pneumatosis of the intestine.

With intestinal pneumatosis, a woman needs to be examined again, since excessive gas formation in the patient's intestines prevented the doctor from drawing any conclusions.