The anatomic and functional features of a healthy kidney in unilateral fetal obstructive uropathy


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Abstract

Objective. To estimate compensatory changes in the healthy kidney in unilateral fetal obstructive uropathy. Subjects and methods. A case-control study was used to prospectively analyze linear and volumetric renal dimensions and blood flow parameters in the renal artery and parenchyma in 29 fetuses with unilateral obstructive defects in the urinary system and in 45 fetuses without these abnormalities at 20 to 40 weeks’ gestation. Results. A compensatory increase in the healthy kidney was found in 20 (68.9%) cases of unilateral fetal obstructive uropathy. At the same time, the most accurate values of the increased volume of the intact kidney were obtained by three-dimensional echography (68.9%) versus the use of its linear dimensions (48.3%). The renal blood flow estimated by pulsed wave Doppler ultrasound did not differ in the study and control groups. At the same time, analysis of 3D power Doppler angiographic findings showed that the intact fetal kidneys in unilateral obstruction became more compensatorily vascularized in the study group than in the control one. Conclusion. In unilateral fetal obstructive uropathy, the healthy kidney displays antenatal compensatory changes characterized by increases in both its linear dimensions and volume and in the degree of vascularization. The latter are manifested at the end of the second trimester and directly related to the degree of collateral kidney damage.

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About the authors

K. V Kostyukov

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: k_kostyukov@oparina4.ru
MD, PhD, Head of the Department of the Ultrasound and Functional Diagnosis

A. I Gus

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_gus@oparina4.ru
physician, Department of the Ultrasound and Functional Diagnosis

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