Unilateral macrocystic dysplasia and contralateral agenesis in a monoamniotic twin

Czech version

Authors: Ostatníková M.; P. Doležal; M. Gábor; Jozef Záhumenský
Authors‘ workplace: II. gynekologicko-pôrodnícka klinika LF UK a UN Bratislava, Slovenská republika
Published in: Ceska Gynekol 2022; 87(4): 278-281
Category: Case Report
doi: https://doi.org/10.48095/cccg2022278

Overview

Objective: We present a case report of a congenital malformation of the uropoetic tract in one of the monoamniotic twins. Case report: A 24-year-old primigravida with male monochorionic monoamniotic twins was diagnosed with congenital malformation in fetus A at 24 weeks of gestation. Ultrasound verified macrocystic dysplasia and contralateral renal agenesis. Planned caesarean section was performed after the observational management of the patient in the 34^th gestational week. In fetus B, a physiological finding was confirmed on the postpartum ultrasonography. In fetus A, CT examination of the abdomen confirmed the finding of left kidney agenesis and polycystic degeneration of the right kidney. Exitus letalis was stated on the newborn‘s 5th day. Conclusion: The occurrence of the described combination of congenital malformation in monoamniotic twins is rare. When dysplasia significantly affects the function of the parenchyma, renal agenesis with multicystic dysplasia of the other kidney is a condition incompatible with life. For the intrauterine survival of the affected fetus, the normal renal function of the twin was important and thus the normal volume of amniotic fluid was maintained. As a result, the fetus did not develop extrarenal symptoms of the Potter sequence in the described case – especially pulmonary hypoplasia and the newborn was able to ventilate spontaneously. The death was caused by the consequences of renal failure associated with anuria.

Keywords:

monoamniotic twins – macrocystic renal dysplasia – renal agenesis

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