Fetal Kidneys

8/8/2019 Fetal Kidneys

1/22


2/22

KIDNEYS CAN BE VISULISED AT11-12 WKS.

RENAL LENGTH IN MMS=GEST.AGE

IN WKS.

EVALUATION OF RENAL

FUNCTION BY SEEING UB ANDNORMAL LIQUOR.

AFTER 14-15 WKS 2/3 OF LIQUOR IS FROM FETAL URINATION& 1/3 FROM PULM.FLUID.

NORMAL AFI IS ESSENTIAL FOR GOOD LUNG

DEVELOPMENT. NORMAL AFI MEANS AT LEAST ONE NORMALLY

FUNCTIONING KIDNEY AND PATENT URINARY TRACTBELOW BLADDER.


3/22


4/22

Measurement of AP diameter ofpelvis in transverse view

>4.00 mms in 2nd & 7.00mms in 3rd tri.

Visualization of ureter alwaysabnormal.

Bladder >3.00 cms. in 2nd &5.00cms in3rd tri.

Main causes are PUJ obstruction, VUJobstruction, PUV & VU reflux


5/22

Hydronephrosis Mild 7.OO mmsMod- 7.00 TO 15.00 mmsSevere >15.00 mms

Indicators of obstructive dysplasia-

- increased parenchymal echogenicity

- parenchymal cysts


6/22


7/22


8/22


9/22

No hereditary transmission.

May be unilateral/bilateral/segmental.

Non communicating cysts of various types.

No cortex or medulla.

No identifiable collecting system.

Cysts usually small in beginning , may enlarge

as some renal function is there. Later againsmall and kidneys may be nonidentifiable.


10/22


11/22

Usually fetal. Those who survive developshepatic fibrosis in early childhood.

Markedly enlarged hyperechoic kidneys, no

CMD. Cysts, if seen, are in medulla (collectivetubular in origin) with peripheral hypoechoiccortex.

Severe oligohyroamnios


12/22


13/22

Rarely seen in utero.

Cysts in cortex and medulla (arising fromnephrons and c. tubules)

Moderate renal enlargement.

Cysts in liver, spleen.

Evaluation of maternal kidneys.


14/22

Communicating cysts---Dilated collecting system

HNNo HU---PUJ obst.

HU---UB/PU not dilatedVUJ obst.

UB/PU dilated-----PUV Non communicating cysts----

Unilateral/segmental , throughout---MDK

Bilat., large, echogenic kidneys , oligo---ARPKD

Mod. enlarged kidneys cysts throughout

maternal renal cysts---ADPKD

Associated with syndromes.


15/22


16/22

Common

Autosomal recessive

25% recurrent risk

Enlarged cystic kidneys

Occipital encephalocele

Postaxial polydactaly


17/22


18/22


19/22


20/22

Rare cause of obstructive uropathy. Almost alwaysfemale child.

Failure of primitive cloaca to divide . GI system &

GU system opens through common opening inperineum. Dilated urinary and GI systems.

Dilated UB with HU and HN. Oligohydroamnios+.

Fold in UB which is margin of communicationbetween UB and usually female genital tract bothof which are filled with urine. Urine goes in colonand mixes with meconium causing calcification.


21/22


22/22

Fetal Kidneys

Documents