Analysis of prenatal ultrasound diagnosis and pregnancy outcome of 56 cases of fetal renal cystic disease

Objective To investigate the prenatal ultrasonographic features of fetal renal cystic disease and observe the associated pregnancy outcomes,and provide evidences for prenatal consultation and pregnancy management of the disease. Methods A retrospective analysis was performed in the prenatal ultrasonographic features of 56 cases of fetal renal cystic disease in the first medical center of Chinese PLA General Hospital from January 1,2015 to December 31,2017,and their pregnancy outcomes were followed up. Results Of the 56 cases,13 had simple renal cyst,10 of them were delivered at full term without abnormality,and labor were induced in the other 3 cases;18 cases had polycystic renal dysplasia,10 of them were delivered at full term,with 1 case received postnatal surgery,and labor were induced in the other 8 cases;15 cases had hereditary polycystic kidney,13 of them were combined with oligohydramnios,only 1 case was delivered at full term and labor were induced in 14 cases;10 cases with other malformations were induced labor.The autopsy results in 14 cases showed that their pathological diagnosis were consistent with the prenatal ultrasound diagnosis.Genetic test was performed in 12 cases,and pathogenic mutation genes were found in 6 cases. Conclusion According to the characteristics of kidney cystic lesions,prenatal ultrasound can provide evidences for prenatal consultation.The cases of simple renal cyst without amniotic fluid abnormality and cases with unilateral polycystic renal dysplasia have good prognosis,but close follow-up should be performed.While,the cases with hereditary polycystic kidney plus oligohydramnios have poor prognosis,inducing labor is suggested.If combined with other organ abnormalities,fetal kidney cystic lesions may be one of the manifestations of a genetic syndrome.Autopsy or genetic test is helpful to find out the etiology of fetal renal cystic disease.