Urine Blockage in Newborn Babies - Diagnosis and Treatment

What Is Urine Blockage in Newborn Babies?

The body relies on the whole urinary system to balance the body’s fluid and natural chemicals. During the prenatal phase of an infant’s life, this whole procedure is handled by the placenta. Only after 12 weeks of pregnancy the fetus starts producing urine, which is handled in the mother’s womb by the placenta. The umbilical cord is responsible for handling the excretion of the fetus’s fluid that is released into the amniotic fluid and mixes with that. The amniotic fluid plays an essential role in the healthy development of the fetus’s lungs.

Occasionally, due to some birth defects such as hydronephrosis or hydroureter, the urinary tract is blocked, and so is the urine. Hydronephrosis is the result of blocked urine that causes inflammation of the kidneys. Depending on the severity of this condition, hydronephrosis can cause permanent damage to the kidneys and urinary tract infections in newborns. On the other hand, the inflammation of the ureters is called hydroureter.

What Are the Causes of Urine Blockage in Newborn Babies?

There are the following conditions that cause urinary blockage in newborns:

• Vesicoureteral Reflux (VUR): It is the condition where the urine flows backward in either ureters or kidneys rather than excreting out. Children with this condition are born with abnormally short ureters and underdeveloped valves. Due to this abnormality of development, the urine refluxes back into the kidneys via the ureter. This can also cause long-term and severe damage to the kidneys and their functions.

• Ureteropelvic Junction Obstruction: Ureteropelvic junction obstruction is the blockage of the junction between the ureter and kidneys, which causes the reduction of the urine flow from the ureter and the increased pressure in the kidneys. This condition can cause long-term harm to the functions and structure of the kidney. This is a condition that usually affects one kidney.

• Bladder Outlet Obstruction: Bladder outlet obstruction is a condition caused by many complications such as bladder cancer, stones, or prostate enlargement. In this condition, the base of the bladder is blocked, which affects the urine flow.

• Posterior Urethral Valves: Posterior urethral valve is the obstructive membrane formed in the urethra. Formation of the membrane hampers the urine flow and enlargement or swelling of the ureter and kidneys. This can further cause permanent damage to the organs and their structure.

• Ureterocele: Ureters carry urine from the kidney to the bladder, and in the ureterocele, the bottom of the ureter is inflamed due to abnormal development of the ureter. This can further cause obstruction between the ureter and the bladder and damage the function and organs.

• Nerve Disease: Nerve diseases such as spina bifida can cause neurogenic bladder due to malformation of the nerve that controls the bladder. This disease affects both urine storage and urine excretion function in babies.

What Are the Syndromes Affecting Urinary Tract?

The following are the syndromes that affect the urinary tract:

• Prune Belly Syndrome: It is a group of rare conditions that causes a weak and absent abdominal wall. Furthermore, this condition can also cause swelling of the ureters, bladder, and undescended testicles in babies. The skin of the belly has a wrinkled and prune-like appearance, hence the name. This condition is usually seen in boys and has complications associated with it, such as hydronephrosis and inflammation of the kidneys.

• Esophageal Atresia: It is a congenital defect causing complications related to the development of the tube connecting the mouth to the stomach (esophagus). Moreover, babies born with this condition also have complications related to the digestive system, urinary tract, or spine.

• Congenital Heart Defects: Congenital heart defects are the group of defects affecting the health of the baby’s heart since the time of birth. Children born with this condition also usually have developmental abnormalities related to the urinary tract.

What Are the Signs and Symptoms of Urine Blockage in Newborn Babies?

The signs and symptoms related to urinary blockage are the following:

• Traces of pus or blood in the urine.

• Change of the color of the urine.

• Irritability.

• Fussiness.

• Fever.

• Diarrhea.

• Frequent urination.

• Reduced appetite.

• Vomiting or nausea.

• Kidney enlargement.

How to Diagnose Urine Blockage in Newborn Babies?

The following are the diagnosis options used for analyzing any defects associated with urinary defects:

1. Prenatal Screening:

• Ultrasound: The ultrasound technique uses sound waves to get an image of the internal organs of the body on the monitors. If the child is facing urine blockage and selling of the kidneys or ureter, this evaluation method can help diagnose and confirm the condition.

• Amniocentesis: This diagnostic method is used for unborn babies. A tin needle is inserted into the amniotic sac through the skin to collect the amniotic fluid sample. This is an effective method to detect birth defects in babies by diagnosing the amniotic fluid.

• Chorionic Villus Sampling: Chorionic villus sampling is the diagnostic method used by collecting placental tissue. It is used to detect birth-related defects and genetic abnormalities in babies.

2. Examination of the Newborn Baby:

• Ultrasound: Ultrasound is the diagnostic method used since the 12th week of pregnancy. Even after birth, it is used to detect any abnormalities related to the urinary tract.

• Voiding Cystourethrogram: During this diagnostic method, the bladder of the baby is filled with fluid containing iodine through catheterization. This fluid makes the blockage or obstruction of the bladder more visible to the X-ray, doctors can diagnose with the X-ray if the child has backward reflux of the urine or obstruction of the ureter.

• Nuclear Scan: During this diagnostic method, a tiny amount of radioactive material is injected into the bloodstream of baby. A unique camera is used to capture the flow of the radioactive material, and if the flow stops or is reduced, it shows some kind of obstruction in the kidneys or ureter.

How to Manage Urine Blockage in Newborn Babies?

Depending on the diagnosis and the severity of the condition, the following are the treatment options for urinary blockage:

• Prenatal Shunt: With the guidance of ultrasound, a thin tube is inserted into the bladder to drain the fluid into the amniotic sac. This procedure is used for severe and fatal cases to prevent damage to organs like lungs or kidneys.

• Antibiotics: Patients with urinary obstruction often have urinary tract infections too. Antibiotics are prescribed to the person to prevent bacterial infection.

• Surgery: In the life-threatening condition of urinary obstruction, the stent (a thin tube) is inserted to drain the blockage and establish normal urine flow. This procedure has many side effects and this can only be recommended for severe cases.

• Intermittent Catheterization: In the condition where a child has nerve disease such as spina bifida, this treatment option is used to empty out the bladder manually. Intermittent catheterization is a self-manageable option for children with nerve disease. This can prevent kidney damage and urinary tract infections in them.

• Follow-Up: Every procedure with this condition requires regular follow-up recommended by doctors. This not only helps to see the result of the treatment but also to keep an eye on any other complication that happens during the treatment.

Conclusion

Urine blockage in newborns is a very serious condition. It not only damages the organs of the body but also causes many health-related complications in them. It is advisable for parents to regularly keep an eye on their children and take them to regular checkups as this can cause life-threatening conditions in them with permanent damage to the organs.