Prenatal Diagnosis of Urethropelvic Obstruction and Assesment of Fetal Renal Function: Case Report

Abstract

Fetal obstructive renal anomalies ar the most common urinary anomaly. Obstuction is particularly is encountered in ureteropelvic junction, vesicoureteral juction or urethra. Accurate localisation of obstruction and status of fetal kidneys are of utmost importance in prognosis and intrauterin management. Thirtythree years old, G6P5A0 women at 20th gestational weeks was refered for anhidroamnios and urinary to deparment of Obstetrics and Gynecology, Yuzüncü Yil Univeristy Medical Faculty. B-mod ultrasonographic examination was likely a posterior urethral valve however, color doppler and pulse doppler examination revealed obstruction cranial to fetal bladder. Pyelourethrocenetsis to evaluate renal function and amnioinfusion was performed. Right renal cortex was thin and hiperechogenic, collecting tubules were dilated. Collecting tubules of right kidney was minimally dilated. Biochemical analysis of aspirated fluid and anhidroamniosis gave irreversible renal damage and pregnancy was terminated. There was left renal duplication and right grade 4 hydronephrosis due to ureteopelvic obstruction. Bladder and urethra was normal. Color doppler and pulse doppler examiation should be incorporated to B-mod examination to assess localisation of urinary obstruction. Uretherocentesis and amniotic fluid index should be examined in order to evaluate prognosis of fetal kidneys.