Clinical Manifestations and Perinatal Outcomes in Pregnancies with Fetal Dysplastic Kidney Disease

Oh, Kie Suk; Kim, Haeng Soo; Yang, Jeong In; Oh, Joon Hwan; Keum, Seung Seop

Abstract

OBJECTIVE
To obtain clinically useful data regarding prenatal diagnosis, proper antepartum counseling and obstetric management in pregnancies with fetal dysplastic kidney disease.
METHODS
We retrospectively reviewed 13 cases of MCDK(Multicystic dysplastic kidney) and PCDK(Polycystic dysplastic kidney), diagnosed by antenatal ultrasound and delivered from June 1994 through July 1999 at Ajou University School of Medicine, Department of Obstetrics and Gynecology, with regard to prenatal ultrasonographic findings, perinatal outcomes, maternal complications and associated fetal anomalies.
RESULTS
The incidence of MCDK and PCDK was one in 1,066 and one in 2,398 births, respectively. Of the 9 cases of MCDK, one case was terminated due to severely associated anomaly, and 6 cases were delivered by spontaneous labor or pitocin induction at term, of which 1 case was delivered by pitocin induction at 36 weeks gestation due to intrauterine fetal death. Two cases were delivered by cesarean section. There were no neonatal deaths in 7 cases of MCDK and they have been followed up to date, and alive. Of the 4 cases of PCDK, 3 cases were terminated by induced abortion or induced vaginal delivery, and 1 case was delivered by cesarean section, which was combined with hypertrophic cardiomyopathy, and the baby died within 24 hours after birth. Perinatal complications consisted of small for gestational age, urinary tract infection, hydronephrosis, acute respiratory failure, acute renal failure, periventricular hemorrhage and laryngomalacia in the neonatal period.
CONCLUSION
It is suggested that antenatal ultrasonography and genetic analysis to evaluate accurate diagnosis and associated anomalies should be performed to manage and councel properly the pregnancies with fetal dysplastic kidney disease.