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Obstetrics » Obstetrics 2nd And 3rd Trimester
multicystic Dysplastic Kidney
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Presentation This was a 2nd trimester scan to corfirm dates.  There were no risk factors.  The mother was 26 years old with a previous normal pregnancy.
Caption: Fetal Measurements Chart
Caption: Fetal Bladder
Description: The fetal Bladder filled and emptied during the 30 minute exam.
Caption: Length of the left fetal kidney
Description: The left kidney is approximately 4cm in length
Caption: Length of the right fetal kidney
Description: The right kidney is 2.76cm in length.
Caption: A transaxial image of both fetal kidneys
Description: There is a discordance between the size and appearances of the right and left kidneys.
Caption: Enlargement of the transaxial view of the kidneys.
Description: There are many cysts within the left kidney. There is mild dilation of the right renal pelvis. The extent of this dilation varied between 2-5mm during the scan.
Differential Diagnosis The enlarged left kidney could contain a mass, be obstructed, or be a multicystic dysplastic kidney.
Final Diagnosis A sonogram performed at another facility at 2 days of age confirmed the presence of a left multicystic dysplastic kidney.
There was reflux in the right kidney and 3 tiny simple cysts were reported.
Discussion Multicystic dysplastic kidney (MCDK) occurs when the normal renal cortex is progressively replaced by many cysts of different sizes.  The kidney eventually fails to function. Unilateral MCDK has a good prognosis if good renal funtion is present in the contralateral kidney.

This disorder usually occurs unilaterally and it is most common on the left.  Anomalies on the contralateral kidney are not uncommon and if the anomaly prevents renal function, the combination is fatal. MCDK can be bilateral and is then fatal.

Associated anomalies other than renal, are esophageal atresia and heart malformations. MCDK is more common in females and its occurrance rate has been reported as high as 1 per 1,000 and as low as 1 per 5,000 pregnancies.
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