Fetal Kidneys
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Transcript of Fetal Kidneys
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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.
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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
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Hydronephrosis Mild 7.OO mmsMod- 7.00 TO 15.00 mmsSevere >15.00 mms
Indicators of obstructive dysplasia-
- increased parenchymal echogenicity
- parenchymal cysts
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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.
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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
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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.
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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.
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Common
Autosomal recessive
25% recurrent risk
Enlarged cystic kidneys
Occipital encephalocele
Postaxial polydactaly
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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.
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