Oligohydramnios associated with bilateral multicystic dysplastic kidneys: Prenatal diagnosis at 15 weeks' gestation
✍ Scribed by Robert J Stiller; Margarita Pinto; Charles Heller; John C Hobbins
- Book ID
- 102329668
- Publisher
- John Wiley and Sons
- Year
- 1988
- Tongue
- English
- Weight
- 379 KB
- Volume
- 16
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Lethal fetal renal malformations are invariably associated with oligohydramnios in late antenatal ultrasound examinations. Controversy exists concerning the contribution of fetal urine production to amniotic fluid volume prior to 20 weeks' gestation. We report a pregnancy complicated by maternal gold usage and fetal bilateral multicystic dysplastic kidney disease in which oligohydramnios was detected at 12 weeks' gestation. To our knowledge, no previous cases of lethal fetal renal anomalies have been made in the first trimester. The early diagnosis of fetal renal anomalies, fetal renal contribution to amniotic fluid production, and possible teratogenicity of gold therapy is discussed.
REPORT OF A CASE
The patient is a 16-year-old woman, Gravida 1, Para 0, with known juvenile rheumatoid arthritis for approximately 10 years. The patient was being treated with oral gold salts, auranofin 6 mg daily, and a nonsteroidal antiinflammatory agent, ketoprofen, 150 mg daily prior to conception. These medications were continued until June 30, 1986; at that time, she was hospitalized for increasing joint pains and difficulty in walking. On admission, pregnancy was detected and obstetrical consultation was obtained.
Real-time sonography (General Electric, Milwaukee, Wisconsin) confirmed the presence of an From the Departments of