[Bilateral renal agenesis at the Department for Diagnosis and Prophylaxis of Fetal Malformation at the Institute Polish Mother's Memorial Hospital with fetal echocardiography in years 1994-2002].

UNLABELLED: There was done 8525 sonographical and echocardiographical examinations in 1994-2002 in the Department for Diagnosis and Prophylaxis of Fetal Malformation (DDPFM) of Institute of Polish Mother's Memorial Hospital. In 22 cases (0.25%) bilateral renal agenesis (BRA) was diagnosed. Till year 1999 the examinations were performed on Acuson 182 XP an since year 2000 on Philips HDI 5000 with Power Doppler. In 6 cases (27%) the suspicion of BRA were diagnosed in others places and in 16 cases (73%) in DDPFM. The average age of pregnant was 25.5 (+/- 4.8) and the average fetal age during first examination at DDPFM 27 weeks and 2 days (+/- 5 days). 83% of pregnant were from low risk group. The ahydramnion was the most frequent diagnosed anomaly (11 cases) and intrauterine growth retardation (IUGR) (4 cases). Till year 1999 BRA was diagnosed based on indirect syndromes: lack of visualization of kidney, the absence of bladder, no improvement after diagnostic amnioinfusion. Since year 2000 BRA was diagnosed based on indirect syndromes and lack of visualization of kidney artery in Power Doppler. In 16 fetuses there were not abnormality in echocardiographical examination. In 5 cases pericardial effusion were diagnosed. In 5 cases cardiomegaly and in 3 cases hypertrophy of heart were diagnosed. Among 22 pregnancies there where 8 (36%) intrauterine deaths, 1 (5%) fetus was born before 32nd week of gestation and 13 (59%) died after birth. 12 (55%) fetuses were delivered in I PMMH and 10 (45%) cases in others hospitals. In 15 (68%) cases there were vaginal delivery and 7 (32%) cesarean sections. The average birth weight was 1530 grams and Apgar score in 19 newborns was 0-1.

CONCLUSIONS: 1. Bilateral renal agenesis is a lethal malformation, which can be suspected during screening obstetrical examination (ahydramnion, IUGR), but it needs confirmation by genetical ultrasound and echocardiographical examination. 2. The mean technique during examination for BRA is Power Doppler.