B/L FETAL HYDRONEPHROSIS
BILATERAL FETAL HYDRONEPHROSIS
Fetal hydronephrosis is the most common congenital anomaly detected by ultrasound. It is the abnormal dilation of urinary canals, and its most frequent cause is physiologic (48%), that resolves spontaneously. Almost, there are some pathologic causes: pelvi‐ureteric junction obstruction (11%), extrarenal pelvis (15%), vesicoureteral reflux and megaureter (9%), ureterocele and double kidney (2%), and posterior urethral valves (1%). The most frequent complication is the renal failure. During prenatal and postnatal period, ultrasound is the election diagnostic method. The urinary tract anomalies are 20% of all congenital anomalies. In fact, hydroneprosis have an incidence of 2–5,5%, and a newborn prevalence of 0,5 – 4,5%. Only 17 – 30% are bilateral with a poor prenatal prognosis. In the second and third trimester oligohydramnios is the first cause; and in the postnatal period this is the first cause of permanent renal impairment.
Post valve constriction with bilateral hydronephrosis In etal usg
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Cases that would interest you
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primi of 14 wks 5 day's USG shows megacystitis bilateral hydronephrosis and CTEV what next USG report attached
Dr. Kishor Jagtap1 Like8 Answers - Login to View the image
34 weeks pregnancy with BL grade IV HUN...n distended UB with mild oligohydramnios...Discus mgmt....@Dr. Mustafa Ameena Parveen @Dr. Sweety @Dr. K Hima Sindhu @Dr. Suvarchala Pratap
Dr. Owais H Dar3 Likes8 Answers - Login to View the image
gravida 2para1 with 5months of amenorrhea came for routine check up.tiffa done. scan showing above findings.short segment of hypocoiling of umbilical cord. unilateral et renal mildpelvicalectaesis 4mm.what is the further management. is quadruple marker needed.
Dr. Gopala Vanaja3 Likes6 Answers - Login to View the image
38 wks pregnancy with oligohydromnios and UB bubble measures approximately 73 mm
Dr. Arun Verma1 Like2 Answers - Login to View the image
SIRENOMELIA / MERMAID SYNDROME / SIRENOMELIA SYNDROME : SIRENOMELIA/ MERMAID SYNDROME IS AN EXTREMELY RARE CONGENITAL DEVELOPMENTAL DISORDER CHARACTERISED BY ANOMALIES OF THE LOWER SPINE AND LOWER LIMBS. ADDITIONAL MALFORMATIONS CAN OCCUR INCLUDING GENITOURINARY ABNORMALITIES, GASTROINTESTINAL ABNORMALITIES, ANOMALIES OF THE LUMBOSACRAL SPINE AND PELVIS AND AGENESIS OF ONE OR BOTH KIDNEYS. PATHOGENESIS : Although the primary molecular defect resulting in sirenomelia remains unclear, two main pathogenic hypothesis namely THE VASCULAR STEAL HYPOTHESIS & THE DEFECTIVE BLASTOGENESIS HYPOTHESIS are proposed. According to the VASCULAR STEAL HYPOTHESIS , fusion of the lower limbs results from a deficient blood flow and nutrient supply to the caudal modern , which in turn results in agenesis of midline structures and subsequent abnormal approximation of both lower limbs. IN DEFECTIVE BLASTOGENESIS HYPOTHESIS, the primary defect in development of caudal mesoderm is attributed to a teratogenic event during the gastrulation stageSuch a defect interferes with the formation of notochord, resulting in abnormal development of caudal structures. SIGNS & SYMPTOMS. 1 ) Fused legs or absent foot structures. 2 ) Unilateral or bilateral renal agenesis. 3 ) Vertebral / spine abnormalities. 4 ) Absence of external genitilia. 5 ) Underdeveloped reproductive system. 6 ) Cardiomegaly. 7 ) Immature / abnormal lungs. 8 ) Absence of bladder, small and large intestines and other organs. 9 ) Urethral agenesis. Genitourinary and gastrointestinal malformations are seen. PRENATAL DIAGNOSIS : Severe oligohydramnios, renal agenesis, congenital heart defects, skeletal abnormalities, single umbilical artery, absence of external genitilia, urethra and anus , single lower extremity . CLASSIFICATION OF SIRENOMELIA : CLASSIFICATION ACCORDING TO STOCKER & HEIFETZ 1987. Classified according to the presence of skeletal elements in the thigh and leg. TYPE I : All thigh and leg bones present. TYPE II : Single fibula. TYPE III: Absent fibula. TYPE IV : Partially fused femurs, fused fibulae. TYPE V : Partially fused femurs. TYPE VI : Single femur, single tibia. TYPE VII: Single femur and absent tibia. Another classification is based on the presence or absence of feet. SYMPUS DIPUS/ SYMMELIA: two feet are present. SYMPUS MONOPUS / UROMELIA : Only one foot is present. SYMPUS APUS : No evidence of any distal foot element. Here ,I would like to share a case of mine . 22 year old, G2 P1 L1 , First normal delivery and healthy alive baby. Non consanguinous marriage. Severe oligohydramnios, absent renal arteries, cardiomegaly and single umbilical artery are scan findings at 27 weeks. Terminated the pregnancy. Diagnosed as sirenomelia after delivery. This baby had the following FEATURES. 1 . Single lower extremity. 2 . Absent anus. 3 . Absent urethra. 4 . Absent external genitilia. 5 . Single umbilical artery . 6 . Single femur and tibia on X - Ray. 7 . Pelvis incomplete.
Dr. Suvarchala Pratap17 Likes21 Answers
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