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2006-08-24-11 Dysplastic kidneys © Cuillier www.thefetus.net/


Dysplastic kidneys  

Cuillier F, MD*, Coignard JP, MD**, Riviere JP, MD***

*    Dept of Obstetrics and Gynecology, Hôpital Félix Guyon, Saint-Denis, Reunion Island, France.
**   Radiologist, Bourbon"s avenue, Saint-Andre, Ile de la Réunion, France.
***  Deparrment of anatomopathology, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France.

This is a 30-year-old woman, G2P1 with a previous family history of kidney disorders. The nuchal translucency and the triple test were normal. At 22 weeks, an abnormal right dysplastic kidney. The fetus had a normal growth. The patient was seen in our antenatal unit at 22, 23, 26, 29 and 31 weeks. The fetal morphology was normal except the abnormal kidney. At 22 and 23 weeks, we could observe the presence of a right dysplastic kidney and a hyperechogenic and small left kidney. The kidneys were located at the lumbar fossa. At 26 and 29 weeks, we observed:

  • The left kidney was abnormal, with absence of corticomedullary differentiation. This kidney was also small.
  • The right kidney also had abnormal corticomedullary differentiation. Some hypoechogenic cysts were located on the peripheral portion of the kidney.
  • The diagnosis seemed to be a severe right dystrophic kidney with poor corticomedullary differentiation and a left kidney, without corticomedullary differentiation in a female fetus.
  • The amniotic fluid was normal.


Nevertheless, at 31 weeks, the lesion progressed. The amniotic fluid was low. The right kidney was more echogenic. The parents decide to consult a nephrologist and they were counseled about the bad outcome of the baby. They decided to perform an interruption of pregnancy. The interruption was done at 32 weeks.

The baby was  female with a normal weight. The two kidneys were analyzed. The diagnosis was confirmed. The kidney parenchyma was atrophic. There was only a fibrous stroma, without glomerules.

 

Note the left echogenic kidney at 23 weeks

Note the two displastic kidneys at 26 weeks

Note the two displastic kidneys at 29 weeks

Note the two displastic kidneys at 31 weeks


 

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