FETAL ULTRASOUND IN DIAGNOSING CONGENITAL RENAL ANOMALIES: A CASE SERIES

Abstract

This case series evaluates the accuracy of fetal ultrasound in diagnosing congenital renal anomalies through the examination of seven cases, comparing prenatal findings with postnatal outcomes. Case 1, at 23 weeks gestation, showed mild urinary tract dilation (UTD A1) with a renal pelvic diameter (RPD) of 5.0 mm, which resolved spontaneously by the follow-up growth scan. Case 2 presented at 31 weeks with an RPD of 9.8 mm (UTD A1), and postnatal scans confirmed persistent dilation (UTD P1), necessitating ongoing monitoring. In Case 3, a 28-week scan revealed a significant left kidney PUJ obstruction with an RPD of 26 mm (UTD A2-3), confirmed postnatally as severe urinary tract dilation (UTD P3) requiring intervention. Case 4, detected at 18 weeks, involved an ectopic right kidney adjacent to the bladder, with the absence of the right renal artery confirmed postnatally. Case 5, identified at 18 weeks, showed bilateral enlarged echogenic kidneys, leading to pregnancy termination at 21 weeks due to a poor prognosis, consistent with similar findings in a previous pregnancy. Case 6, at 20 weeks, showed anhydramnios and bilateral renal agenesis, confirmed by the absence of renal arteries and kidneys on imaging, resulting in pregnancy termination at 21 weeks. Case 7, at 12 weeks, revealed a dilated bladder, distended posterior urethra, and bilaterally enlarged echogenic kidneys, indicating a posterior urethral valve, leading to termination at 14 weeks due to the severity. These cases highlight the crucial role of fetal ultrasound in early detection and management of congenital renal anomalies, demonstrating its capabilities and the necessity for confirmatory postnatal diagnostics.