Renal oligohydramnion

Distended fetal bladder, also known as fetal megacystis, usually points to lower urinary tract obstruction (LUTO) which is most commonly caused by posterior urethral valves (PUV) in the male fetus. We present a short case-series of fetal megacystis without oligohydramnion where primary vesicoureteral reflux (VUR) was the leading aetiology. These cases also displayed a high rate of kidney dysplasia with early-onset renal dysfunction. By contrast, late-onset diagnosis of isolated megacystis, i.e without significant renal parenchymal or upper urinary tract abnormalities, had a surprisingly benign postnatal course with spontaneous resolution after birth...

BACKGROUND: Renal oligohydramnion (ROH) is predominantly caused by congenital abnormalities of the kidney and urogenital tract (CAKUT). Although the number of neonates born with chronic renal failure is small, they provide many challenges, and among the most problematic are respiratory management and long-term treatment of chronic renal failure. We studied the value of prenatal and perinatal variables to predict survival and the general long-term outcome of our ROH population. Method...

Although it becomes vitally important only after birth, renal function already plays significant role in maintaining fetal metabolic equilibrium. The kidneys significantly contribute to production of amniotic fluid. Adequate amount of amniotic fluid is needed to stimulate the intrauterine fetal respiratory activity. Intrauterine breathing is essential for lung development. As a result, oligohydramnion is conducive to pulmonary hypoplasia. The latter may lead to neonatal demise soon after birth. In extrauterine life kidneys eliminate nitrogen containing metabolic byproducts...

Autosomal dominant polycystic kidney disease(ADPKD) is rarely observed in the neonatal period. We report 2 cases of ADPKD who showed bilateral enlarged, hyperechoic kidneys and severe hypertension. It is difficult to differentiate ADPKD from autosomal recessive polycystic kidney disease (ARPKD) based on the initial clinical presentations in this period. In both cases, bilateral enlarged kidneys and severe hypertension were detected without oligohydramnion and respiratory distress. The mother of case 1 has polycystic kidneys...

We report on an innovative therapeutic attempt in a case with obstructive uropathia in a fetus. Placement of an anterograd urethral stent was performed in the 26th gestational week. Transurethral catheterization via the fetal megacystis, the urethra and the orificium externum of the penis was feasible during fetal endoscopy (Fetendo). During serial ultrasound scans from the 27th to the 36th gestational week a normalization of the amniotic fluid volume was observed. The postpartal evaluation demonstrated that the kidney structure, values of kreatinin serum levels and renal clearance were in the normal range...

AIMS: Ruptures of the uropoietic system resulting in either urinary ascites or urinoma are rare complications in the neonate. Although ruptures without clear predisposing factors are described, in most cases they are associated with obstructive uropathy. The diagnosis is often delayed and the prognosis is related to the degree of renal damage. There is discussion about possible protective mechanisms of the rupture for renal function in patients with obstructive uropathy. METHODS: We retrospectively analyzed the clinical presentation, predisposing factors and the renal function before and after treatment of 10 neonates with a rupture of the pyelum or urinary bladder in our hospital...

Renal tubular dysgenesis (RTD) is a disorder characterized by neonatal renal failure and regular gross renal architecture, although the histological features of immature and shortened proximal tubules lead to neonatal death. The pathogenesis of this condition includes a congenital familial condition, a twin-twin transfusion syndrome, and an angiotensin-converting enzyme inhibitor intake by the mother. The clinical picture shows an association with oligohydramnia, pulmonary hypoplasia, and skull ossification defects...

The prune belly syndrome was first described in 1839 by Frolich. Till now about 300 cases have been reported in literature. The complete form of the syndrome is presented by a classic triad that is seen only in boys and is incompatible with life. The etiology of the syndrome is uncertain. Genetic factors, intrauterine infections, adverse mechanical factors have been implicated. The prenatal diagnosis relies on the ultrasonographic findings of oligohydramnion, renal anomalies, and non-immune fetal hydropsy. The present case concerns a newborn of male sex suffering from the most severe and rare form of the syndrome...

Two newborns with glomerulocystic kidney disease manifesting as late onset oligohydramnion and neonatal anuria, yet without severe respiratory distress, are presented. They had a similar perinatal course and associated clinical manifestations. No associated congenital or inherited malformation syndrome could be defined. Both infants' parents were first degree cousins and belonged to the same small Bedouin tribe, and neither they nor the infants' siblings had polycystic kidneys or renal insufficiency, pointing to either a possible genetic etiology or a common external toxic exposure...

A full-term newborn developed oliguric renal failure at 24 hr of life, which persisted for several days. Her mother ingested therapeutic doses of nimesulide, a non-steroidal anti-inflammatory (cyclo-oxygenase-2 inhibitor) drug, during the last 2 weeks of pregnancy. She was found at delivery to have developed oligohydramnion, esophagitis, and a bleeding peptic ulcer. The infant's fractional excretion of sodium was very low (0.5%) pointing for a severe vasoconstrictive mechanism involved. Renal sonogram showed hyperechogenic medullary papillae, which resolved during convalescence...

In 74 pregnancies suspected for a small-for-gestational age (SGA) fetus by ultrasound measurement of the abdominal circumference, Doppler measurements of the fetal aorta and umbilical artery were performed. The renal and middle cerebral arteries were studied by color flow mapping. 47 infants were indeed growth retarded. The resistance- (RI) and pulsatility-indices (PI) of all vessels and their ratios were calculated. The superior parameter evaluated by receiver operating characteristic was the ratio of the PI of the middle cerebral artery in comparison to the PI of the umbilical artery at a threshold value of 1...

Three pregnancies in which indomethacin was given for several days to arrest premature delivery ended in oligohydramnion, meconium and perinatal death. These findings, together with previous information from animal experimentation and experience in humans reported on in the literature, show that indomethacin, a prostaglandin synthetase inhibitor, may interfere with the normal uteroplacental circulation, amniotic fluid production, renal functions and neonatal cardiopulmonary adaptation. The possible hazards of indomethacin treatment during the third trimester of pregnancy are discussed...

Pulsed Doppler ultrasound was used in the differential diagnosis of 22 cases suspected of bilateral malformations of the foetal kidneys. In cases of kidney malformations, the pulsatility indices (PI) of the umbilical artery and the foetal aorta were in the normal range. In cases showing pathological PI values of both vessels, we found a severe intrauterine growth (IUGR) retardation with oligohydramnion. These results underline the importance of pulsed Doppler as a non invasive means in the management of oligohydramnions to differentiate among bilateral kidney malformations and IUGR...