Single Umblical Artery - Pediatric Oncall

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Question
My wife was diagnosed with sua(single umbilical artery) and a wide right kidney pelvic(14mm while the left kidney pelvic was only 4mm)in her 3rd month of pregnancy. It was our second baby boy. She went through 5 US until she gave birth on the 38th week. The baby weight was approx. 9 pounds. After 2 days he lost almost 1 pound. The doctors took a blood test and found that he had creatinine 3 and the potassium was high too. The baby went through US test and he was diagnosed with Hypoplastic kidneys that hardly function. After another day or two we realized that he has CRF (Chronic Renal Failure). My question is if they(the Doctors) could diagnosed it during the pregnancy or at least tell us about the risks with sua since nobody did. They said all the time that because there is enough fluid in the mother's uterus it means that the baby urine so the kidneys work properly and we don't have to worry about. Now we have to worry for the rest of our lives with a sick baby that is doomed to suffer. Your prompt reply would be greatly appreciated. Please HELP!!!!
Answer
Before we can comment whether you should have been alerted beforehand about the seriousness of the condition, there are a few things that need to be clarified: You have mentioned that your baby was diagnosed as wide right pelvis with a single umbilical artery in 3rd month. Usually ultrasound does not pick up pelvic sizes till 15-16 weeks of gestation. Also, what were the kidney sizes on ultrasound- were they large like a polycystic kidney disease or small to be hypoplastic? Also, ultrasound is a operator dependent procedure and depends a lot on the person who does the ultrasound and also on the ultrasound machine whether it is the 4th or 5th generation or one of the older models. Creatinine of 3mg% on day2 of life is very high and is suggestive of severe disease. Also the birth weight of the baby was a little too much (9 pounds). Did the mother have diabetes during pregnancy? Does your child have any other congenital malformation? Single umbilical artery is known to be linked with congenital malformations. It is not possible to comment at the moment as the entire picture is not falling into its place. Back to All Questions

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