Your health questions answered

Will dilated kidneys trouble my baby after it's born?
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Ultrasound scan has me worried

"I've just had a 24-week scan that shows my baby's kidneys are mildly dilated. We have been told that the baby could have urine infections and might even need surgery after birth. What does this all mean? Can dilated kidneys cure themselves, or do they always cause problems?"

As the quality of ultrasound scans during pregnancy has improved, obstetricians are now able to monitor a baby's progress much more closely. Dilated kidneys are now quite a common finding in antenatal scans. It is usually only part of the kidney – the renal pelvis – that is dilated or widened. This is the funnel-shaped area where urine begins its journey from the kidney to the bladder. If the renal pelvis is only a little bit wider than normal, it is very unlikely to cause any problems after birth. If the renal pelvis is severely dilated, the cause may be a narrowing or blockage that is preventing urine from flowing into the bladder. In one study, about two-thirds of children with severe widening of the renal pelvis developed urine infections or needed surgery after birth. Those with mild dilatation did not have any further problems. Let the obstetricians keep an eye on things with regular scans. If the widening remains mild, it will most likely look after itself without any help from paediatricians.



Is there any treatment for bronchiectasis?

"My husband has bronchiectasis, which causes constant coughing. It is very tiring and tiresome, both for him and for me. His consultant has signed him off and says there is no treatment. Is there any way of helping him?"

Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD), that's a bit like chronic bronchitis. It causes a section of the bronchial tree to become widened and scarred. These passages normally contain some muscle and elastic tissues, but bronchiectasis destroys the muscle and elastic and allows mucous and infection to accumulate in the lungs. Although there is no cure, some treatments will help. Your husband may benefit from long-term, regular antibiotics, while physiotherapy may also help. If your husband does not take long-term antibiotics, it is vitally important the he be given them at the first sign of infection. Some people with bronchiectasis have cystic fibrosis, a genetic condition present from birth. The British Lung Foundation website will give you more information: www.lunguk.org/bronchiectasis.



Please send your questions and suggestions to A Question of Health, The Independent, Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

Readers write

MH thinks motion sickness in cars is primarily caused by bad driving:

The cure for motion sickness (in many cases) is to teach the driver to change gear properly. If you throw any person about in a vehicle (sudden braking, sudden acceleration, jerky gear changes) then is it any wonder that they subsequently experience motion sickness?

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