ABSTRACT
OBJECTIVE: To evaluate the possibility of fetal compensatory renal hypertrophy with a unilateral functioning kidney. METHODS: A nomogram of renal length was established from 254 normal fetuses. Renal length was also obtained in 14 fetuses with unilateral renal agenesis and 22 fetuses with a unilateral multicystic kidney. RESULTS: Compensatory renal hypertrophy, defined as a renal length > 95th percentile for gestational age, occurred in 16 of 36 cases (44.4%). CONCLUSIONS: Compensatory renal hypertrophy is detectable in utero and may occur as early as 22 weeks' gestation.
Subject(s)
Adaptation, Physiological , Kidney/abnormalities , Kidney/pathology , Polycystic Kidney Diseases/diagnostic imaging , Polycystic Kidney Diseases/physiopathology , Ultrasonography, Prenatal , Female , Gestational Age , Humans , Hypertrophy/diagnostic imaging , Hypertrophy/physiopathology , Kidney/diagnostic imaging , Kidney/physiopathology , Observer Variation , Pregnancy , Sensitivity and SpecificityABSTRACT
OBJECTIVE: We sought to investigate the amniotic fluid index for individual gestational sacs of twin pregnancies. STUDY DESIGN: Four hundred eighty-eight patients with normal diamniotic twins were examined between 14 and 40 weeks' gestation. The dividing membrane between twin fetuses was identified. An amniotic fluid index was then obtained for each gestational sac. RESULTS: The median amniotic fluid index in individual twin gestational sacs rises slowly from 14 to 16 weeks' gestation to 23 to 28 weeks' gestation and then gradually declines. The median amniotic fluid index values by gestational age for twin A and twin B are not statistically different. Although twin pregnancies have a slightly lower median amniotic fluid index value than singleton pregnancies, the difference is also not statistically significant. CONCLUSION: Individual amniotic fluid indices can be obtained in twin pregnancies, and the values are comparable with those of singleton gestations.
Subject(s)
Amniotic Fluid/metabolism , Pregnancy, Multiple/metabolism , Female , Gestational Age , Humans , Pregnancy , Reference Values , TwinsABSTRACT
OBJECTIVE: Our purpose was to determine the effect of routine second-trimester and third-trimester ultrasonographic examinations on the prevalence of detectable and operable adnexal disease. STUDY DESIGN: The study group consisted of 7996 pregnant women between 13.0 and 42.8 weeks' gestation. The size and architectural pattern of any detectable adnexal masses were noted. RESULTS: A total of 328 of the 7996 (4.1%) women in the study group had 335 ultrasonographically detectable adnexal masses; 309 of the masses were unilocular or had a single thin septation and 26 were architecturally complex. Of the ovarian cysts 252 of 309 (81.6%) had a mean diameter < 3.0 cm; 60% of the 252 patients in this subgroup had serial ultrasonographic examinations; 43 of the unilocular cysts resolved, and 17 have persisted for up to 2 years. There is a statistically significant trend toward decreasing frequency of ovarian cysts with increasing gestational age (chi2 for linear trend; P < .00001). Eighteen of the 7996 had an exploratory laparotomy (1 operation per 444 deliveries) during pregnancy or in the postpartum period. In addition, 1 patient had a paratubal cyst excised at the time of postpartum bilateral tubal ligation. Pathologically confirmed lesions included 8 benign cystic teratomas, 3 mucinous cyst adenomas, 2 paratubal cysts, 2 corpus lutea, 1 serous cystadenoma, 1 follicular cyst, 1 endometrioma, and 1 ovarian fibroma. CONCLUSION: Ovarian cysts are found in 4.1% of second-trimester and third-trimester obstetric ultrasonographic examinations. Most ultrasonographically detectable cysts are < 3.0 cm in diameter and usually resolve. The frequency of exploratory laparotomy for adnexal disease is not significantly different from that in reports before the widespread use of obstetric ultrasonography.
