Complementary role of magnetic resonance imaging after ultrasound examination in assessing fetal renal agenesis: a case report

Abstract

IntroductionUltrasonography is used routinely during pregnancy to screen and detect fetal abnormalities. However, there are some conditions like anhydramnios (a prevalent state in renal agenesis) or maternal obesity that may limit the diagnostic accuracy of ultrasonography. Magnetic resonance imaging has proven to be useful when ultrasound alone is insufficient to make a correct diagnosis.Case presentationWe present the case of a 22-year-old Caucasian woman who was admitted to our unit at the 26th week of gestation for a detailed anatomy scan. Anhydramnios and failure to visualize the kidneys, bladder and renal vessels were confirmed with the use of sonography in our department. Since the lack of amniotic fluid limited the acoustic window for fetal ultrasonography, a magnetic resonance imaging scan was requested to confirm suspected renal agenesis. A fetal magnetic resonance imaging scan was performed and confirmed the suspected diagnosis. A baby boy was born by breech vaginal delivery after spontaneous onset of labor at the 34th week of gestation. The boy weighed 1690g, with Apgar scores of 6 and 4 at two and five minutes respectively, and died one hour after delivery. The diagnosis of bilateral renal agenesis was confirmed on autopsy.ConclusionsThe aim of this study was to evaluate the potential contribution of magnetic resonance imaging in diagnostic procedure after inconclusive ultrasound examination during the assessment of fetal urinary tract abnormalities in the third trimester.

Are non-invasive or minimally invasive autopsy techniques for detecting cause of death in prenates, neonates and infants accurate? A systematic review of diagnostic test accuracy

“…However this only amounted to 54 studies in total as some artices described different tests from the same study. Of the 134 indirect evidence papers or abstracts, 133 were synthesised41–174 as well as a single trial record 175. None of the seven included trials identified from trial registries reported interim or final results and only four remain active 176–179.…”

“…For both risk of bias and applicability to the review question, the majority (n=129) had some concerns,41 42 44–67 69–87 89–149 151–170 172–174 and five had a high level of concern43 68 88 150 171 (figure 3).…”

“…In a stillbirth population, the number of studies favouring the index test was higher than those favouring the reference standard. Eighteen studies favoured antenatal ultrasound,41 52–54 57 75 77 78 85 89 90 98 108 124 128 133 137 166 and 11 favoured autopsy 50 61 65 82 86 91 110 148 159 160 167…”

“…In a stillbirth population, there was a mixture of results, with seven studies favouring the index test,69 75 77 133 159 160 166 three studies favouring the reference standard65 85 167 and one having a split opinion 52…”

Burden of Congenital Defects Diagnosed through Ultrasonography in Soba Fetomaternal Unit, Khartoum, Sudan

“…Second-trimester scan, between 18 and 22 weeks, remains the standard for fetal anatomical assessment worldwide. However, significant improvement in detecting fetal abnormalities in the first trimester of pregnancy is also recognized [4].…”