El papel del ultrasonido fetal en el diagnóstico de las malformaciones urinarias congénitas, el nuevo reto para el urólogo. Presentación de un caso

Abstract

We present herein the ultrasonographic follow-up of renal ectasia in a male twin fetus.

Clinical case

A 29-year-old woman with a history of 3 pregnancies, one normal delivery, and one cesarean section, had first trimester ultrasound screening at the Center for Opportune Screening of the Instituto de Salud Pública del Estado de Guanajuato (ISAPEG) that revealed a dichorionic diamniotic twin pregnancy with negative screening test results.

At 20.1 weeks of gestation, a structural ultrasound detected left renal ectasia in one of the twins. The 2010 Antenatal Hydronephrosis Grading Classification of the Society of Fetal Urology was used to measure and classify the ectasia of the left renal pelvis.

The ultrasonographic follow-up of the left renal pelvis in the twin detected with hydronephrosis according to the abovementioned classification was: at 20.1 weeks of gestation the anteroposterior diameter of the left renal pelvis was 4.5 mm; at 24 weeks of gestation it was 5.3 mm; at 28 weeks of gestation it was 8.1 mm; and at 30.5 weeks of gestation it was 11.2 mm. When re-evaluated by the Fetal and Pediatric Pathology Department, the diagnosis was grade 3 hydronephrosis.

Prenatal screening in Mexico is advancing with innovative technology and the urologist must become familiar with prenatal diagnoses to be prepared to meet this new challenge.