Nine of 23 established types of short-limbed dwarfism are always incompatible with life. Current state-of-the-art ultrasonic equipment and techniques combined with the establishment of longitudinal growth curves for fetal long bones have made possible the early prenatal diagnosis of lethal skeletal dysplasias. In addition to significantly shortened and/or bowel femurs, features include hydramnios, fetal hydrops, and protuberant fetal abdomen, all easily identifiable with ultrasound. The availability of early prenatal diagnosis of these skeletal dysplasias has placed increased importance on early ultrasonic evaluation of at-risk populations, providing an additional diagnostic parameter to complete the genetic workup.
Two cases of significant hydronephrosis of pregnancy and their management are detailed. Measurements of calyceal diameters in control and pregnant patients of varying gestational ages are presented. Calyceal dilatation in pre-and postvoid states for all patients examined is compared, with no differences noted. Although there was a general trend toward increasing calyceal diameters throughout pregnancy, high intragroup variation was present in each group. There were no significant differences detected between gestational age groups and between right and left kidneys. Ultrasonography can be used as the initial method of evaluation in symptomatic pregnant patients. The absence of hydronephrosis virtually eliminates obstructive disease, while significant hydronephrosis may be present without disease. The hydronephrosis of pregnancy is highly variable and exhibits wide ranges of physiologic change. Medical management should be based on symptomatology rather than "hydronephrosis" as a pathologic diagnosis.
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