Abstract
IntroductionUltrasonography is used routinely during pregnancy to screen and detect fetal abnormalities. However, there are some conditions like anhydramnios (a prevalent state in renal agenesis) or maternal obesity that may limit the diagnostic accuracy of ultrasonography. Magnetic resonance imaging has proven to be useful when ultrasound alone is insufficient to make a correct diagnosis.Case presentationWe present the case of a 22-year-old Caucasian woman who was admitted to our unit at the 26th week of gestation for a detailed anatomy scan. Anhydramnios and failure to visualize the kidneys, bladder and renal vessels were confirmed with the use of sonography in our department. Since the lack of amniotic fluid limited the acoustic window for fetal ultrasonography, a magnetic resonance imaging scan was requested to confirm suspected renal agenesis. A fetal magnetic resonance imaging scan was performed and confirmed the suspected diagnosis. A baby boy was born by breech vaginal delivery after spontaneous onset of labor at the 34th week of gestation. The boy weighed 1690g, with Apgar scores of 6 and 4 at two and five minutes respectively, and died one hour after delivery. The diagnosis of bilateral renal agenesis was confirmed on autopsy.ConclusionsThe aim of this study was to evaluate the potential contribution of magnetic resonance imaging in diagnostic procedure after inconclusive ultrasound examination during the assessment of fetal urinary tract abnormalities in the third trimester.
Highlights
Ultrasonography is used routinely during pregnancy to screen and detect fetal abnormalities
The aim of this study was to evaluate the potential contribution of magnetic resonance imaging in diagnostic procedure after inconclusive ultrasound examination during the assessment of fetal urinary tract abnormalities in the third trimester
Sometimes ultrasound examination might be hampered by maternal obesity, oligo/anhydramnios, fetal position and reverberation caused by bones
Summary
Ultrasonography is used routinely during pregnancy to screen and detect fetal abnormalities. Since the lack of amniotic fluid limited the acoustic window for fetal ultrasonography, a magnetic resonance imaging scan was requested to confirm suspected renal agenesis. A fetal magnetic resonance imaging scan was performed and confirmed the suspected diagnosis. Ultrasonography (USG) is an ideal imaging procedure during pregnancy. It is noninvasive, inexpensive, with no radiation risk and provides an opportunity to visualize the fetus. When USG is unable to provide a definitive diagnosis, further investigation with more sophisticated methods is necessary. One of these methods is magnetic resonance imaging (MRI), which plays an increasingly important role in fetal visualization. In contrast to USG, it is an operator-independent technique
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