VP12.11: Fetal hydronephrosis and a atypical genital tract malformation

Abstract

Congenital renal diseases are significant causes of morbid mortality in children. There is a strong association between malformations of the urinary system and the genital tract. In the traditional Potter classification, the type IV is characterised by cystic kidneys in association with lower obstruction. However, the anomalies of the vagina generally do not influence urinary system development. We describe a 23-year-old lady, low risk pregnancy, 22 weeks of gestation. The ultrasound revealed oligohydramnios (amniotic fluid index 4.8 centimetres), adequate fetal growth, normal placenta and Doppler. In the morphology was identify bilateral hydronephrosis. The patient was followed up and counselling by the neonatal risks. She refused any intrautero intervention. On 31 week's gestation the amniotic fluid has become normal (AFI =15.0 cm), but the kidneys findings were the same. In this time, the lower abdominal evaluation was identified an unspecific hypoechoic cyst located posterior to bladder. On 40 week's gestation Caesarean delivery was performed at and the newborn weighed 4.3kg. The postnatal ultrasound findings were bilateral hydronephrosis and hiperechogenic parenchymal texture of the kidneys, normal bladder and abdominal hipoechogenic cyst. This cyst was located in topography of the vagina and was suggestive of hydrocolpos. The exam showed an imperforate hymen. The prompt surgical treatment was performed in the fourth day of life by abdominal section. The surgical findings confirmed the hypothesis of hydrocolpos. The newborn went to home and we are following the case closely. The importance of this case is in calling attention to different etiology to fetal hydronephrosis. The congenital malformation of the genital tract must be remembered, since other causes investigated so far have been negative. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.