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Fetal Genitourinary System

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Fetal Genitourinary System

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    1. Fetal Genitourinary System Anatomy and Anomalies I

    2. Embryology

    3. Sonographic Anatomy - Kidneys Identified by 12-14 wks Echo poor renal pyramids Echogenic sinus fat Mild pelviectasis normal 18% of fetuses after 24 weeks

    4. Sonographic Anatomy - Kidneys

    5. Sonographic Anatomy - Kidneys

    6. Sonographic Anatomy - Kidneys

    7. Normal Measurements

    8. Renal Pelvis Measurements

    9. Renal Pelvis Measurements

    10. Sonographic Anatomy – Bladder The urinary bladder is routinely identified by 20 weeks, and indicates renal function. It empties and fills in the normal fetus in 30 - 45 minute cycles.

    11. Sonographic Anatomy – Bladder

    12. Sonographic Anatomy – Adrenals Adrenal glands are relatively large in a fetus, seen as oval masses superior to the kidneys on sagittal scan. Transversely, they appear as long, thin echogenic lines of medulla surrounded by thicker sonolucent rims of cortex.

    13. Sonographic Anatomy – Adrenals

    14. Sonographic Anatomy – Adrenals

    15. Sonographic Anatomy – Genitalia Genitalia may be evaluated to assist in the differential diagnosis of genitourinary anomalies and/or chromosome syndromes.

    16. Sonographic Anatomy – Female

    17. Sonographic Anatomy – Male

    18. Renal Agenesis The congenital absence of one or both kidneys. Unilateral occurs 1:1,000 births and is asymptomatic Bilateral (Potter’s syndrome) consists of: bilateral renal agenesis pulmonary hypoplasia facial anomalies patient presents as small for dates

    19. Renal Agenesis – Unilateral

    20. Renal Agenesis – Bilateral Sonographic findings in BRA: severe oligohydramnios between 16-28 weeks is strongly suggestive of renal anomalies absent kidneys and urinary bladder bladder not distended due to anuria

    21. Renal Agenesis – Bilateral

    22. Renal Dysplasias Type I Autosomal recessive polycystic kidney disease (ARPKD) Infantile Type II Multicystic dysplastic kidney disease (MDK) Type III Autosomal dominant polycystic kidney disease (ADPKD) Adult Type IV Cystic renal dysplasia

    23. Polycystic Kidney Disease Inherited kidney disorder characterized by many bilateral cysts, which cause enlargement of the total renal size while reducing, by compression, the functioning renal tissue.

    24. ARPKD - Type I Perinatal - renal failure occurs in utero Neonatal - occurs within first month of life Infantile - occurs by 3-6 months Juvenile - occurs between 1-5 years

    25. ADPKD – Type III Characterized by replacement of renal parenchyma with multiple cysts of variable sizes Liver, pancreas cysts may also be present Diagnosed later in life

    26. Sonographic Findings -Bilaterally enlarged, hyperechoic kidneys -Increased kidney: AC ratio -Oligohydramnios -Absent, or small, fetal bladder. -Loss of cortico-medullary differentiation

    27. Sonographic Findings

    28. Sonographic Findings

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