Question about amnio at 35w for hydronephrosis(long) — The Bump
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Question about amnio at 35w for hydronephrosis(long)

Hello ladies,

I've been going back and forth on this for a few days, and I thought I had made my decision (and I think I still have) but then I remembered this board, and thought I would see what you all thought since many of you have been in a similar position. I would truly appreciate any thoughts or experiences you may want to share after reading my post.

Anyways, background = with DS I had placenta previa, and at 21w with this pregnancy, I ended up in L & D for a bleeding scare where there were also placenta issues. Well, about 2 months ago, we were sent to Tufts Medical Center to check on the placenta, and they determined that it was okay this time around, but they found some fluid on the baby's kidney and said we'd check it again at 34 weeks. The dr. did ask if my Downs testing came back normal as this is both a soft marker, but also something that is pretty common in baby boys. My early testing (NT scan & bloodwork) was normal, and came back as a 1 in 1000 chance. 

This past Friday was our 34 week u/s back at Tufts to check on the baby's kidney. Baby now has fluid on both his kidneys instead of just one. It's still a mild case of hydronephrosis, but enough for concern. He'll have to have an u/s when he's born to determine if he'll need surgery or not, and he'll have to be on antibiotics, etc....The dr. made it clear that it's not a severe case, but it will make the newborn days a little more stressful.

After explaining all of that, she brought up Down's. She said that it is only one soft marker, and all his other markers were fine (head, heart, nasal bone, femur was 'reassuringly long'), etc....But with the kidney issue, my risk would be more like 1 in 500 or 600 instead of the initial 1 in 1000. So, she (and my regular OB when I called her) both said that he is very likely fine, chances of Down's are still super small, but nothing can ever be ruled out 100%. For my own peace of mind, she offered me an amnio right that day. I didn't take it today because DS was with us, and he was already in meltdown mode. 

So I have an appt. for Thursday. Results would be 7-10 days. My c/s is in 4 weeks from today. So, I either wait for amnio results or his birth for peace of mind. Only risk of amnio right now is about a 1 in 200 chance of preterm labor. So, I guess I'm just wondering what you would all do in this situation. I know the Down's risk is still so, so low, but I can't help but feel stuck on it. And regardless of that, the kidney issue is there no matter what.

If you were in this same exact position at 35w, with the same exact decision/choice/statistics, what would you do? 

Aidan Jake 7/25/08 Cooper Cole 7/27/10 Tessa Morgan 8/9/12

Re: Question about amnio at 35w for hydronephrosis(long)

  • I had an amnio after my 22 week ultrasound that detected a heart defect, since many syndromes are connected to heart defects. I would consider the procedure to have very minimal risk if done with an experienced doctor under ultrasound. The procedure was actually not a big deal at all and I had no side effects. 

    Having said that, I would only have an amnio if it would give you information that would better prepare you and the docs for your baby's birth. At 35 weeks, I don't think I would have the amnio. You are so close to delivery that I don't think it would be worth it if I were in your shoes. Like I have said quite a few times before, getting an amnio is a very personal decision. If knowing whether your baby has Down Syndrome or not is eating away at you, it might be worth it for you to have it done.  

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  • The risk of the amnio is early labor and at this point, you are pretty far along so I would worry much less about what would happen even if you went into labor.  Having said that, don't feel pressured to do the amnio.  A lot of babies have hydronephrosis and it resolves at birth - my daughter's kidneys were twice the normal size in utero and when she was born, there was no issue.  I know several other babies that had the same result. If there are no other markers and your NT scan came back fine, I would probably opt not to do the amnio.  But if you do opt to have it, definitely don't worry - the risk of early labor is small and you are far along.

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  • I think the question is "What would you do with the information an amnio provided?" 

    I lurk on this board because my kids have speech issues, but when I was pregnant with DD, her quad screen came back with "high" odds for Downs.  I think it was 1:400 or so (which is still pretty low, when you do the math).  Scared us to death.  They moved our anatomy u/s back a few weeks to give us some time to make some decisions.

    In the time we were waiting for u/s, we decided that we would not terminate for Downs Syndrome alone.  We had the u/s and no markers were shown, so our odds decreased a bit.  They still offered us an amnio then and there and we decided against it - given that we still wouldn't terminate and it wasn't worth the risks of miscarriage.  They also gave me the option of having an amnio at 34-35 weeks, just for peace of mind and that if I went into preterm labor, at least the baby would be mature enough to survive. 

    I initially thought I wanted to do that, just so that there would be no surprises at birth, but when the time came, we didn't. 

    I don't know if that helped you.  I guess what I'm saying is that late into the pregnancy, all it's going to do is help you know what to expect.  Good luck!

  • My DD was born with Hydronephrosis.  It was discovered at 20 weeks and it was in both of her kidneys.  When we went to MFM, they told us about our chances for Down's and we opted out of the amnio - to us, it didn't matter.  

    She wasn't born with Down's, but she did have to have surgery on her left kidney to correct the problem.   

    I would be happy to talk to you about it if you needed to! 

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  • lboerslboers member

    i had amnio done at 27 weeks. we are still waiting for the final results (only 3 weeks later, not too bad). we think the information will either give us peace of mind and allow me to enjoy the rest of my pregnancy (if the results are normal) and give us the chance to prepare for her birth and her aftercare and also grieve the idea of having a perfectly healthy little baby (if the results come back showing the condition we expect she has). i know that knowing in advance won't make all the sad, scary emotions go away when she's born, but i want to be able to be as happy as possible when she gets here. i just can't imagine having to find our at her birth that there were all these issues.

    so to answer your question, if i were you, in your exact situation, i would have it done. no question. but that is me, and only you can really make that call. although to me it seems as if you, whether you realize it or not, have already made the decision. 


  • We were in the EXACT same position at 34/35 weeks.  My son had a heart defect and a few other "mysterious" issues (ones that cleared up on their own by 36 weeks), so they suspected a chromosomal abnormality.  They didn't specifically suspect Downs because he didn't have any other typical markers other than the heart defect - nasal bone was developed, bones proportianal, etc.  As one doctor told me, your chances are low, like 1 in 800 (I don't remember the exact), but someone always has to be that 1! 

    Anyway, they offered an amnio at 34 weeks for peace of mind but I declined because I didn't want to risk a preemie, especially if he was facing other health issues to begin with, ya know?  It was absolute torture for me those last few weeks not knowing, so in that respect I wish I had known.  On the other hand, once my little guy had arrived I didn't care at all that he had Down syndrome because I was so head over heels in love with him!  Plus, I had gone through months of anguish with the not knowing, so I was done stressing by that point!  It's a personal choice.  I guess if I had to do it over, I probably still would not get the amnio, especially this far along (maybe earlier I would).  Good luck, and just know that your little one will be here VERY soon and you don't have to wonder anymore!

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