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Puv suspected in anomaly scan
My wife is 23 weeks pregnant and in her 22nd week anomaly scan we got this update -
Impression :
Single gestation corresponding to a gestational age of 22 Weeks 1 Day Gestational age assigned as per LMP
Placenta - Anterior
Presentation - Variable
Liquor - Adequate
Estimated fetal weight according to BPD,HC,AC,FL :- 554 + / - 55.4 gms.
BILATERAL HYDRONEPHROSIS WITH LOWER URINARY TRACT OBSTRUCTION - SUGGESTIVE OF POSTERIOR URETHRAL VALVE - Suggested peadiatric urologist consultation
Right renal pelvis 8.4mm
Left renal pelvis 6.9mm
SDP = 5.1
Please suggest we are super worried
Answers (7)
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Hai no need to worry, Actually many 90 % unilateral Dilatations will resolve, But here bilateral, one is mild another is moderate,this is common surgical problem.Consultant urologist , for recent protocols.
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I understand this is worrying to hear during pregnancy — but please know that many babies with suspected PUV do well with proper monitoring and treatment after birth.
The report shows bilateral hydronephrosis (both kidneys slightly swollen). This can happen when there is some obstruction in the baby’s urine flow.
One possible cause is Posterior Urethral Valve (PUV) — a condition seen only in boys, where a small tissue flap in the urethra slows urine flow.
Good news: Liquor is adequate, which usually means the kidneys are still functioning well.
PUV can range from mild to severe. Many mild–moderate cases do well after birth with treatment.
The fact that Amniotic fluid is normal, and Kidney pelvis measurements are still in the mild–moderate range are reassuring signs.
Next Steps
Detailed follow-up scans every 2–4 weeks
To monitor kidney size, Bladder appearance and Amniotic fluid level
Changes over time help doctors understand how significant the obstruction is.
Consultation with a fetal medicine specialist / pediatric urologist. They will explain treatment options after birth
Most babies undergo a simple endoscopic procedure in the first few weeks of life to remove the obstruction.
Once the baby is delivered:
A kidney ultrasound is done within 24–48 hours
A MCU test (micturating cystourethrogram) confirms the diagnosis
If PUV is present, a tiny camera procedure removes the valve tissue. Many babies recover well and lead normal lives.
Health Tips
Contact your doctor if:
You feel reduced baby movements
Scan later shows falling liquor
Rapid increase in kidney swelling
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Yes , u need to talk to pediatric surgeon
I can counsel or guide you on what to do
Plz consult on personal chat with me
It’s a high risk pregnancy
Your baby having congenital anomaly known as posterior urethral valve
Next Steps
Urgent talk to doctor (peds surgery )
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Please get a repeat scan. If the findings are confirmed, then please consult a Pediatric surgeon to discuss management plan.
Will have to keep a close to watch at the subsequent scans for progression of renal swelling.
Next Steps
Please consult your obstetrician and a pediatric surgeon to understand possible scenarios of management after birth.
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Step 1 would be to get another scan done by a radiologist who specializes in fetal medicine to confirm. If it is still the same report then consult a pediatric urologist for further planning.
Once the child is delivered safely, get an ultrasound kub, ensure kidney function, electrolytes and BP is checked after birth.
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I totally understand your concern. Before suggesting treatment, I would like to ask a few questions to ensure the correct management can be provided.
Contact me on Practo or WhatsApp chat.
Contact number: 97012307 two nine
Dr. G. Avinash MBBS, MD (Pediatrics) Fellowship in Neonatology
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Dr. Venkatesh Badugu
Pediatrician
9 yrs exp
Hyderabad
Get a second scan again with other radiologist who specialist in Fetal medicine
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.