Multicystic dysplastic kidneys, bilateral

Albana Cerekja MD, PhD*; Carlo Figliolini MD PhD**; Juan Piazze MD PhD***

*    Ultrasound Division, ASL Roma B, Rome, Italy.
**   Reparto di ostetricia e ginecologia, Ospedale Fatebenefratelli San Pietro Rome, Italy.
***  Ultrasound Division, Ceprano Hospital, Ceprano, Italy.

Multicystic dysplastic kidney is a renal dysplasia resulting from a complete obstruction at either the renal pelvis or proximal ureter prior to the 10th week of gestation. Bilateral disease or contralateral agenesis in unilateral dysplastic kidney is fatal.

Case report

This is the case of a  31 years old patient (G2P1) with non-contributive history. First trimester ultrasound examination evidenced a NT of 2.8 mm for a crown-rump length of 74 mm. Nasal bone was present and ductus venosus flow was antegrade. Amniotic fluid volume was normal.

The patient was scanned at 16+6 weeks for a scheduled amniocentesis.

Both kidneys were big, echogenic and with multiple cysts located predominantly at the periphery. Urinary bladder was not seen. There was some pericardial fluid around the right ventricle, but there were no other anomalies. There was marked oligohydramnios (AFI 7.4 cm).

Due to the bilateral condition and fatal prognosis, parents opted for pregnancy termination and amniocentesis was declined.

Here are some images and videos at 16+6 weeks showing big echogenic kidneys with numerous cysts situated predominantly at the periphery. Look at coronal views, abdomen is much larger than thorax.

Images 1-8: 16+6 weeks of pregnancy; the images show big echogenic kidneys with numerous cysts situated predominantly at the periphery.

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Images 9, 10: 16+6 weeks of pregnancy; Image 9 shows small pericardial effusion; Image 10 shows oligohydramnios with amniotic fluid index 74 mm.

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Videos 1, 2: 16+6 weeks of pregnancy; the images show big echogenic kidneys with numerous cysts situatedpredominantly at the periphery.

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