The cold gel on my side felt like appropriate payback for the daily cold gel torture I impose on my patients as I search for fetal heart rates. The cold gel on my side was looking for something different. The sonographer scanned my kidneys looking for cysts.
“So it says you have a family history of multicystic kidneys?” she questioned. “Who’s had them?”
“Oh, no one else? Did they trace them back to anyone else in the family?”
“Well, she had Down Syndrome, so it’s possible it could been from that. But no one else in the family.”
I had been putting off this ultrasound. Mabel had multicystic kidneys, which we generally attributed to the Down Syndrome, but in theory could have had other origins. It can also be spontaneous or have a hereditary component. Children who are diagnosed with multicystic dysplastic kidney disease (MCDK) often have a parent who turns out to have the disease as well, albeit undiagnosed. When parents have the condition, there is a chance they can pass it on to their children.
So, I was encouraged to get my kidneys checked- for my own health and to see about any risk of recurrence in future pregnancies. I hemmed and hawed about it. It was easy just to chalk Mabel’s kidneys up to the Down Syndrome (kidney issues are more common in children with DS than the general population). I wasn’t sure I wanted to know. I figured (naively) that I was healthy. I’ve never even had a UTI. And if I did have MCDK then it would be yet another thing I would worry about in future pregnancies, but something that wouldn’t be diagnosable until mid pregnancy anyways. And it wouldn’t change my management- the golden question in my field. If a test wouldn’t change the management, then why do it? Do I want the additional worry of an increased of kidney disease, oligohydramnios, poor prognosis and neonatal death, when there is nothing I could do about it? . Ultimately I decided it’s important to know for my own health. I want to be healthy for subsequent pregnancies.
“No cysts,” she said as she scanned my right. “And none here either,” as she finished up on my left.
I would be lying if I said I wasn’t relieved. I’m not sure whether the sonographer saw the lone tear that I let escape.