[Prenatal diagnosis and clinical prognosis of fetal hyperechogenic kidneys].

OBJECTIVE: To study the prenatal diagnosis and clinical significance of fetal hyperechogenic kidneys.

METHODS: Thirty one cases with fetal hyperechogenic kidneys were prenatally diagnosed with ultrasound. Autopsy was conducted and histological examination of the kidney was performed when pregnancy was terminated. A close follow-up was given for cases continuing pregnancy. Umbilical cord blood was collected for fetal chromosome analysis after delivery.

RESULTS: (1) 6 fetuses were complicated with other organ abnormalities, 3 fetuses had abnormal chromosome, and 2 cases had a family history. (2) 12 cases chose to terminate pregnancy, 10 of whom were oligohydromnios. Causes for fetal hyperechogenic kidneys were infantile polycystic kidney disease (IPKD, 10 cases), adult polycystic kidney disease (APKD, 1 case), polycystic kidney dysplasia (PKD, 1 case) after postmortem histological examination. (3) Nineteen cases continued pregnancy, 2 neonates with oligohydramnios died during neonatal period, both of them were IPKD; 3 cases that were IPKD, IPKD and KPD respectively died 3 months, 8 months and 1 year after birth, respectively; one case presented with hypertension symptom 26 months after birth, which was diagnosed as IPKD. The other 13 cases had no clinical manifestation and a close following-up is being undertaken for them at present.

CONCLUSIONS: (1) Fetal hyperechogenic kidneys could be caused by IPKD, APKD, or PKD, and are sometimes a normal variant. (2) Amniotic fluid volume is a key factor for prognosis; a suggestion for termination would be given to cases with fetal hyperechogenic kidneys and oligohydromnios. (3) For cases with fetal hyperechogenic kidneys, a complete and careful ultrasonography should be given to both parents and fetus, and fetal chromosomal analysis is suggested prenatally.