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Review
. 2011;3(3):165-74.

Prenatal diagnosis of congenital renal and urinary tract malformations

A Hindryckx, L De Catte  1
Affiliations
Review

Prenatal diagnosis of congenital renal and urinary tract malformations

A Hindryckx et al. Facts Views Vis Obgyn. 2011.

Abstract

Congenital abnormalities of the kidneys and the urinary tract are the most common sonographically identified -malformations in the prenatal period. Obstructive uropathies account for the majority of cases. The aim of prenatal diagnosis and management is to detect those anomalies having impact on the prognosis of the affected child and -requiring early postnatal evaluation or treatment to minimize adverse outcomes. In this paper, we summarize the embryology of kidneys and urinary tract, the normal sonographic appearance through-out pregnancy and the prenatal diagnosis of their congenital malformations.

Keywords: CAKUT; Prenatal ultrasound; antenatal hydronephrosis.

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Figures

Fig. 1
Fig. 1. Normal ultrasound image of the fetal kidneys and bladder. A. First trimester fetal kidneys at both sides of the lumbar spine. B. The fetal bladder between the umbilical arteries as seen in the first trimester of pregnancy. C. Decreased echogenicity and beginning of cortico-medullary differentiation in second trimester fetal kidneys.
Fig. 2
Fig. 2. Ultrasound appearance of autosomal recessive polycystic kidney disease: bilateral markedly enlarged hyperechogenic kidneys without cortico-medullary differentiation.
Fig. 3
Fig. 3. Typical ultrasound image of multicystic kidney disease: multiple, non-communicating cysts of varying size replace the normal renal parenchyma.
Fig. 4
Fig. 4. A first trimester foetus with a megacystis (arrow) and renal dysplasia: small, hyperechogenic kidneys with dilated pelvis (thick arrows).
Fig. 5
Fig. 5. The diverse etiology of fetal hydronephrosis (adapted from Woodward et al., 2002).
Fig. 6
Fig. 6. Severe hydro-ureteronephrosis due to vesico-ureteral junction stenosis: severely dilated renal pelvis (arrow) and dilated ureter (thick arrow). Mild pyelectasis in the contralateral kidney (*).
Fig. 7
Fig. 7. The sonographic aspect of a ureterocoele: the terminal part of the ureter is dilated within the bladder (arrow).
Fig. 8
Fig. 8. Clinical algorithm for the differential diagnosis in fetal hydronephosis.
See this image and copyright information in PMC

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