I recently had my anomaly scan at 22 weeks, which indicated a "possible problem" with my baby's kidneys. According to the report, both the left and right kidneys are described as being 'normal' but the left pelvis is measured at 7.2mm and the right at 7.3mm, which has been recorded in the report as 'moderate dilation.' Both cortexes are described as 'normal,' but all of these findings have been recorded under the heading of 'Hydronephrosis' and I now have to have another scan at 32-40 weeks and see a Neonatal Consultant to discuss "what will happen to your baby" (the words used in the appointment letter I received.)
I was told by the nurse performing the scan at the time and another mother whose daughter was also diagnosed with these symptoms that they are common and in most cases no cause for alarm, but the wording of this recent appointment letter has of course aroused some concern in me.
I tried looking up 'Bilateral Hydronephrosis' on the internet in order to get some facts and ease my mind -- but I've only succeeded in scaring myself half to death instead with the bleak picture painted by most of the articles I found.
I don't know who or what to believe anymore and I'm driving myself to despair worrying about the implications of these scan findings. My appointment with the Neonatal Consultant isn't until late April but I'm going to go nuts with worry long before then. I'd be very grateful if you could provide me with some advice and information. I don't really want sugar-coating, I'm just looking for some realistic feedback, please.
Thank you in advance,
Your dilemma precisely sums up the problem with prenatal diagnostic testing. First of all, diagnostic testing puts the focus on problems that can occur in babies' development during pregnancy. Even though many mothers can retain a sense of blissful optimism, if you receive worrisome test results, or if you have had any prior experience with childbearing crisis, or if for any other reason you are well aware that bad things do happen, then this focus on looking for problems can be extremely stressful.
Secondly, when screening results aren't squeaky clean, the health care practitioner is obligated to follow-up, even when a test is notorious for yielding "false positive" results -- false alarms where in most cases, further testing reveals that the baby has really been fine all along. For example, in your case, a result of "bilateral dilation of the renal pelvis" is a common result that only indicates to the lawsuit-cautious doctor the need for further testing, and is not an indication of bilateral hydronephrosis. There is another test for bilateral hydronephrosis that can be carried out in a few more months, and most likely, further testing will show that your baby's development has been healthy and normal. But in the meantime, this testing process puts you through a wringer of needless worry for your baby. This is truly unfortunate, considering your baby is most probably just fine.
Thirdly, prenatal diagnostic testing is not a perfect indicator of what is going on with your baby. Even with the latest medical advances, doctors cannot examine every aspect of your baby's development and condition. They can only rule out some, but not all problems. Plus, for the tests that do exist, doctors look for results in the normal range, but it's a fact that different babies develop at different rates in different areas throughout pregnancy and infancy, and just because your baby is outside the norm, doesn't mean that your baby's development is defective. Furthermore, even when a baby is truly, absolutely fine today, testing never offers a complete guarantee for what the future holds.
One way to avoid prenatal diagnostic testing anxiety is to avoid prenatal diagnostic testing. After all, prenatal diagnostic tests do not promote your baby's health, they merely identify problems, and in some cases, such as chorionic villis sampling (CVS) or amniocentesis, can actually cause problems that risk your baby's life. Nor do diagnostic tests lead to a treatment or cure for chromosomal or developmental defects. (In contrast, it is important for you to be monitored -- e.g., keeping an eye on your blood sugar, blood pressure, and signs of preterm labor -- as many maternal conditions can be treated for the benefit of your baby.) And if you absolutely wouldn't consider terminating a pregnancy, then you may well decide to skip diagnostic testing unless you want prenatal assessment so you can envision your future and possibly make important plans about the birth and care of your baby.If you just "want to know," or if your baby is at risk for having certain problems (such as chromosomal anomalies due to advanced parental age -- and even here, you can decide whether 35 is a reasonable cut off, or if 42 works better for your situation) then you must consider that you have to be willing to tolerate a certain level of anxiety created by testing. Doctors and midwives are also aware of which tests tend to give false alarms, and you can ask for information about the false positive rate, as well as the rate for complications from testing techniques, and take this into account as you balance the risks and benefits for you and your baby.Of course, even if you choose to avoid prenatal testing, this doesn't automatically eliminate anxiety, it just eliminates a specific avenue for anxiety. So, you weigh the anxiety of testing, waiting for results, and having some, probably incomplete information- against having little information and trusting fate and nature.
Finally, diagnostic testing or not, whenever you find yourself in an anxiety-provoking situation, there are steps you can take to calm yourself physically, emotionally, and spiritually. It can help to practice stress reducing habits such as deep breathing, meditation, exercise, rest periods, reducing your work load, journaling, positive imagery, or talking to a trusted friend or counselor. When you're unsure of what's happening with your baby, focus on positive assumptions, and banish the negative ones, which will only drain you. Take one day at a time, focusing on what you can know about your baby right at this moment, and dismissing those fears that arise from your imagination or catastrophic predictions for your future. Take a wondering attitude, and trust that whatever unfolds, you have the babies you are meant to have, and that you can find meaning in everything that happens to you and your little ones. Trust the process, and embrace the journey you and your baby are on.
Warmly,-- Debbie and Mara
The Childbirth Complication Expert Team
Deborah L. Davis, Ph.D. and Mara Tesler Stein, Psy.D. are the authors of Parenting Your Premature Baby and Child: The Emotional Journey, a 2004 National Parenting Publications Awards "Gold Award" winner. They also collaborated on Parent: You and Your Baby in the NICU (2002), as part of the nationwide March of Dimes NICU Project. They.ve been invited to regularly contribute to Advances in Neonatal Care, a neonatal nursing journal; their first article appears in Spring 2005. They are the founding members of Partners in Perinatal and Pediatric Consulting, which promotes developmentally supportive care for babies and parents, as well as collaboration between families and health care professionals.
Dr. Stein is a clinical psychologist in private practice, specializing in the emotional aspects of coping with crisis and adjustment around pregnancy and parenting. She is regularly invited to lecture and give workshops on these issues throughout the country to conferences of physician and nursing groups, doulas, and lactation consultants. Since 1997, she has been consulting with organizations and providing training to health care providers, guiding their efforts to improve the level of psychological support and developmentally supportive care to families during and subsequent to perinatal crisis.
Dr. Davis is a developmental psychologist, researcher, and writer who specializes in perinatal and neonatal crisis, medical ethics, parental bereavement, parent education, and child development. Dr. Davis is the author of four books for bereaved parents, Empty Cradle, Broken Heart (Fulcrum, 1991; 1996), Loving and Letting Go (Centering, 1993; 2002), Fly Away Home (Centering, 2000) and Stillbirth, Yet Still Born (PILC, 2000). She is also on the Board of the Pregnancy Loss and Infant Death Alliance (PLIDA.org) and is regularly invited to write articles for professional periodicals and parent support materials.