I’ve spent seven hours in the last two days in two of the best hospitals in the province, if not the country.
The baby has been scanned to what really is an excessive degree (but as the radiologist at the second hospital was telling me today, even when the hospitals are linked to share reports, it’s only documentation. They never share images. And no radiologist will trust another radiologist’s report if they can’t see the images that were used to determine the report. So I’ve now had three anatomy scans in nine days. The only bright spot is the two hospitals will only be able to partially bill the province for their scans, as you can only bill for one anatomy scan per pregnancy.)
The end result of all of these scans is as follows:
1. The baby is very flexible and can put his/her feet over his/her head and then play with his/her toes, wreaking havoc for techs who are trying to get clear images of one hand or one foot with no apparent extraneous digits.
2. The baby is growing normally and looks great.
3. The baby still has no left kidney. It is not hiding in the pelvis and there is no artery leading anywhere on that side like there is on the right. All techs and radiologists are quite sure it is not there.
4. The right kidney looks perfectly normal and appears to be functioning well as the amniotic fluid levels are good. The baby helpfully voided the bladder during the scan at the first hospital, which is another indication of a working kidney. The kidney is not any bigger than one would expect, but the doctors think it will probably get bigger to compensate for the absence of the other one.
5. The baby quite possibly will have some anomalies in the genitals, but we’ll have no way of knowing until after s/he is born. Possibilities include a missing fallopian tube or ovary or testicle, or issues with the vas deferens, or an oddly shaped uterus. Nothing we can do about this and we’ll just have to wait and see. It’s not uncommon with missing kidneys because the systems are linked to the same point of development.
The plan going forward is as follows:
1. Scan again in 5 weeks at the hospital where I will be delivering to check fluid levels and see if the right kidney is getting bigger, plus a consult with the paediatrician there to sort out what sort of tests will need to be run after birth. I am anticipating a referral to a paediatric nephrologist at the children’s hospital, and I may well meet with him/her before baby arrives just so we have everything in place.
2. Ultrasounds at some point for Q. and I to confirm that we each have two kidneys, as we don’t have proof of this. The genetics counselor wants to be sure it is something random and not something inherited. She’s pretty sure it is, but would like to just check off that box. Apparently unilateral renal agenesis (which is the fancy term for being born with one kidney) is around 1 in 1,000 births.
There is nothing in this diagnosis that requires me to move my pregnancy out of the care of the midwives, and there is no reason to think the baby will need to stay in the hospital after birth- the tests can all be done as an outpatient. Since we opted to do the Harmony screening, we already know the baby has no chromosomal issues. The only way to get more information would be through an amniocentesis. Both the genetics counselor and the maternal fetal medicine specialist offered it, but both also agreed with my assessment that there is no medical indication right now that such testing is warranted or, indeed, likely to tell us anything more. From my point of view, it’s a no brainer- invasive test with a risk of miscarriage (even if very low) to probably not learn anything more? No thank you.
Oh yes, and 3. I am now referring to this baby as Phaselus (or P. for short) for the duration of the pregnancy, which is Latin for kidney bean.