V KIDNEYS CAN BE VISULISED AT

11-12 WKS.
V RENAL LENGTH IN MMS=GEST.AGE
IN WKS.
V EVALUATION OF RENAL
FUNCTION BY SEEING UB AND
NORMAL LIQUOR.
V AFTER 14-15 WKS 2/3 OF LIQUOR IS FROM FETAL URINATION
& 1/3 FROM PULM.FLUID.
V NORMAL AFI IS ESSENTIAL FOR GOOD LUNG
DEVELOPMENT.
V NORMAL AFI MEANS AT LEAST ONE NORMALLY
FUNCTIONING KIDNEY AND PATENT URINARY TRACT
BELOW BLADDER.
V Measurement of AP diameter of
pelvis in transverse view
 ¦4.00 mms in 2nd & 7.00mms in 3rd tri.
 Visualization of ureter always
abnormal.
 Bladder ¦3.00 cms. in 2nd &5.00cms in
3rd tri.
 Main causes are PUJ obstruction, VUJ
obstruction, PUV & VU reflux
V Hydronephrosis ²Mild 7.OO mms
Mod- 7.00 TO 15.00 mms
Severe ¦15.00 mms
V Indicators of obstructive dysplasia-
- increased parenchymal echogenicity
- parenchymal cysts
V No hereditary transmission.
V May be unilateral/bilateral/segmental.
V Non communicating cysts of various types.
V No cortex or medulla.
V No identifiable collecting system.
V Cysts usually small in beginning , may enlarge
as some renal function is there. Later again
small and kidneys may be nonidentifiable.
V Usually fetal. Those who survive develops
hepatic fibrosis in early childhood.
V Markedly enlarged hyperechoic kidneys, no
CMD. Cysts, if seen, are in medulla (collective
tubular in origin) with peripheral hypoechoic
cortex.
V Severe oligohyroamnios
V Rarely seen in utero.
V Cysts in cortex and medulla (arising from
nephrons and c. tubules)
V Moderate renal enlargement.
V Cysts in liver, spleen.
V Evaluation of maternal kidneys.
V Communicating cysts---Dilated collecting system³
HN³No HU---PUJ obst.
HU---UB/PU not dilated³VUJ obst.
UB/PU dilated-----PUV
V Non communicating cysts----
Unilateral/segmental , throughout---MDK
Bilat., large, echogenic kidneys , oligo---ARPKD
Mod. enlarged kidneys cysts throughout³
maternal renal cysts---ADPKD
V Associated with syndromes.
V Common
V Autosomal recessive
V 25% recurrent risk
V Enlarged cystic kidneys
V Occipital encephalocele
V Postaxial polydactaly
V Rare cause of obstructive uropathy. Almost always
female child.
V Failure of primitive cloaca to divide . GI system &
GU system opens through common opening in
perineum. Dilated urinary and GI systems.
V Dilated ¶UB· with HU and HN. Oligohydroamnios
+.
V Fold in ¶UB· which is margin of communication
between UB and usually female genital tract both
of which are filled with urine. Urine goes in colon
and mixes with meconium causing calcification.