A 10 year audit of antenatal ultrasound detection of renal disease.

Abstract

During a 10 year period, a renal tract anomaly was suspected on antenatal ultrasound in 125 fetuses, an incidence of five per 1000 births. 107 live births resulted. Three of six babies with renal failure were stented antenatally. A chromosome anomaly was present in three fetuses (2.4%). No live birth resulted in 14 pregnancies associated with oligohydramnios and no visible fetal bladder. Of those with renal agenesis or bilateral cystic dysplasia, one had a chromosome defect and a further four had extrarenal anomalies. Nine fetuses demonstrated isolated parenchymal hyperechogenicity and trisomy occurred in two of four with bilateral change in enlarged kidneys. All 14 babies with unilateral renal cysts had normal renal function postnatally, but only three of the cystic kidneys showed function. Antenatally, typical multicystic change was seen in 10, and smaller unevenly distributed cysts in four kidneys. Contralateral parenchymal echogenicity and/or pelvicalyceal distension indicating dysplasia was identified in four fetuses. Of 78 fetuses with isolated pelvic with or without calyceal distension the outcome was completely normal in 59% with unilateral, and in 48% with bilateral changes. One baby with unilateral and three with bilateral changes required dialysis or renal transplantation. One of four babies with antenatal ureteric distension had renal failure. Only one of six fetuses with bladder distension is alive in renal failure after in utero stenting.

The role of magnetic resonance imaging in refining the diagnosis of suspected fetal renal anomalies

“…It was reported that unilateral hydronephrosis is the most common fetal renal anomaly and normal amniotic fluid volume is the usual finding, but oligohydramnios is associated with bilateral renal anomalies (18,19). Also, it was reported that the presence of a normal amount of amniotic fluid does not eliminate the possibility of a urinary tract abnormality nor guarantee normal renal function after birth (20,21).…”

Multicystic Dysplastic Kidneys : Antenatal Diagnosis

“…Ultrasound is able to demonstrate the fetal bladder shortly after the 11 th week of gestation when the kidneys start production of urine and it is possible to document the changes of nephrogenesis which continue until 38 weeks of gestation. The proportion of renal abnormalities diagnosed by antenatal sonography has increased from 15% in 1984 to 80% or more in the recent studies [3][4][5].…”

Single trocar retroperitoneoscopic nephrectomy for unilateral multicystic dysplastic kidney in children

“…The incidence of MCDK is approximately 1 in 2,500 newborns [1]. Gradual involution is noted in a significant number of patients [2][3][4][5][6].…”