So About Those Kidneys....Warning! Super-long Post

Susannah Liz had a rough day yesterday.

It all started back in January, when we went to the Center for Maternal and Fetal Medicine at Lenox Hill Hospital for the 20-week anatomical sonogram, a routine procedure during pregnancy. They do a lot of detailed measurements—of the baby's thighs and head and organs and god knows what else.

When the doctor came in to give us the results, he drew a picture of two kidneys attached to a bladder by two ureters. He said our baby had a condition called bilateral hydronephrosis, which means that the renal pelvis, the area in the kidney where urine collects before being drained into the ureter, was more dilated than normal in both kidneys. He said it was a common finding at this stage that could resolve itself in utero. He also thought we might want to consult a pediatric urologist just in case. Cases that don't resolve have to be treated with antibiotics and/or surgery. He stressed that the kidneys were functioning and that the level of amniotic fluid was good, which meant the baby was peeing.

So it wasn’t the best news but it wasn’t the worst either. Unfortunately, the condition did not resolve itself in utero and continued to progress as the pregnancy wore on.

We did meet with a pediatric urologist in the spring who was kind and who said that no matter what, the baby would need antibiotics after birth to reduce the risk of a kidney infection. Further treatment could not be determined until the baby was out of the womb in the world. She added that sometimes the ultrasounds make the situation look worse than it really is.

We also had to keep returning to the Center for Maternal and Fetal Medicine for ultrasounds every two weeks and then every week for the last two months of pregnancy. The kidneys began to look like a rind around the ever-growing renal pelvis--a sign that there was an obstruction causing the dilation. Fortunately the level of amniotic fluid remained normal, as did the baby’s heartbeat, weight and movement. Even though the kidneys weren’t perfect they were still doing what they needed to do.

Fast forward to Susannah’s birth. Even though she looked very healthy, the urologist wanted her under close observation, so Susannah was in the newborn intensive care unit for two days. She started the antibiotics and underwent a couple of tests, all of which determined that her kidneys were working. She also continued to prove this by peeing on many an examining room table.

Surgery is still something that is a possibility as she continues to grow and change. Yesterday we had a rather hellish morning at the hospital where Susannah underwent a renal scan. They inserted an IV into her hand (hence the bandage in the photo, taken at home later that night). Then they injected this dye that essentially lit up her kidneys and allows the doctor to see if one is functioning better than the other. We should get the results later this week. The next step could be simply another ultrasound in a month or so. Or the next step could be discussing which kidney to operate on.

It’s all a bit weird because when you look at Susannah you’d never guess that she’d be anything except perfectly healthy. If it were not for the prenatal ultrasounds, we would have no idea that her kidneys had a problem.

All this information is not to worry you! In fact we want everyone to know that we were more stressed about this during the pregnancy than we are now. Now she is in our arms and smiles and scowls and pees and poops with wild abandon. We have to shuttle ourselves to more doctors’ appointments than we’d like, but whatever. We are glad we know what we know.

One more thing: Susannah is tough. When they were sticking the needles into Susannah’s foot and hand, trying to find a vein for the IV, she barely cried. In fact, she wails more during diaper changes than she did yesterday at the hospital. Proof that she is a total badass, don’t you think?