Ch. 15 Fetal Genitourinary System

Question 1

The fetal kidneys can be identified as early as

Answer 1

12-14 weeks

Question 2

The fetal urinary bladder can be seen as early as —- weeks and should be routinely seen by — weeks

Answer 2

10 weeks, 16 weeks

Question 3

The fetal bladder should fill and empty every

Answer 3

20-30 minutes

Question 4

T or F, we routinely visualize the fetal ureters

Answer 4

False. They are seen only when dilated

Question 5

What size should the adrenals be in comparison to the fetal kidneys?

Answer 5

The adrenals should always be smaller than the kidneys

Question 6

What anomaly is associated with unilateral renal agenesis?

Answer 6

Single umbilical artery

Question 7

Bilateral renal agenesis is associated with what condition?

Answer 7

Potters syndrome

Question 8

What does potters syndrome consist of?

Answer 8

Bilateral renal agenesis, pulmonary hypoplasia, characteristic facies, and limb deformities secondary to oligohydramnios

Question 9

Sono finds of bilateral renal agenesis

Answer 9

Severe oligohydramnios (between 16-28 weeks strongly suggests renal anomalies)
“lying down” adrenal glands in the renal fossae, mimicking kidneys
absent renal arteries

Question 10

Age-related renal pelvis measurements

Answer 10

13-20 weeks AP measurement 5mm
20-30 weeks AP measurement 8mm
30-term AP measurement 10 mm

Question 11

AP Renal pelvis measurements

Answer 11

< or = mm Normal
5-10 mm Probably normal, follow up
> or = 10 mm 85% have anatomic anomaly

Question 12

Inherited disorder characterized by symmetric renal enlargement by multiple small cysts. These cysts cause enlargement of total renal size while compressing functioning renal tissue

Answer 12

Autosomal recessive polycystic kidney disease (ARPKD) AKA Potters Type I

Question 13

Sono finds of ARPKD or, Potters syndrome

Answer 13

Enlarged, echogenic, hyperechoic (due to multiple cysts)
oligohydramnios
small bladder

Question 14

Renal disorder that occurs when there is obstruction of the kidney during its development which leads to the formation of cysts replacing normal renal parenchyma

Answer 14

Multicystic dysplastic kidney (MCDK) AKA Potters type II

Question 15

Sono finds of potters type II, bilateral

Answer 15

Multiple, peripheral, randomly located variable sized cysts
no fetal bladder seen if renal insufficiency is present
possible oligo

Question 16

How do the sono finds of Unilateral MCDK differ from bilateral MCDK?

Answer 16

UNI - normal contralateral kidney
the bladder will be seen in the presence of adequately functioning renal tissue ( unlike bilateral)

Question 17

What is the most common cause of fetal hydronephrosis

Answer 17

Ureteropelvic junction obstruction (UPJ obstruction)

Question 18

Sono finds of UPJ obstruction

Answer 18

dilated renal pelvis
thinning of the renal cortex in chronic states
NO hydroureter

Question 19

Where does UPJ obstruction occur

Answer 19

From the renal pelvis into the ureter

Question 20

What is the LEAST common cause of hydronephrosis

Answer 20

Ureterovesicular obstruction (UVJ obstruction)

Question 21

Where does UVJ obstruction occur?

Answer 21

At the point where the ureters enter the bladder

Question 22

With ureter duplication, often the ureter draining the upper pole will insert ectopically and will result in a

Answer 22

Ureterocele (herniation of the distal ureter into the bladder)

Question 23

A tortuous cystic intra-abdominal “mass” in the fetal pelvis

Answer 23

Congenital or obstructive megaloureter

Question 24

Term for dilation of a ureter

Answer 24

Ureterectasis

Question 25

UVJ stenosis will result in varying degrees of

Answer 25

Hydroureter and hydronephrosis

Question 26

Most bladder outlet obstructions are found in which gender?

Answer 26

Males

Question 27

What is the most common cause of bladder outlet obstructions in male fetuses

Answer 27

Posterior urethral valves

Question 28

What is the most common cause of bladder outlet obstructions in female fetuses?

Answer 28

Cloacal malformations or urethral atresia

Question 29

Sono finds of posterior urethral valve obstruction (PUV)

Answer 29

Massive bilateral hydro and hydroureter
dilated bladder with “KEYHOLE” sign
male sex
bladder wall thickening
moderate to profound oligo \

Question 30

Congenital folds of the urethra act as valves and obstruct urinary flow

Answer 30

Posterior urethral valve obstruction

Question 31

This condition is not compatible with life as there is no amniotic fluid after 16 weeks and pulmonary hypoplasia is certain due to complete obstruction

Answer 31

Urethral atresia (can occur in Female and Male fetuses”

Question 32

A rare and complex malformation that is essentially a convergence of the GI and genitourinary tracts. The single opening may become obstructed and result in dilatation of both GI and GU tracts

Answer 32

Cloacal malformations

Question 33

A cystic mass that is located between the fetal anterior abdominal wall and the anterior portion of the urinary bladder

Answer 33

Patent urachus aka Urachal cyst

Question 34

What is the most common cause of prune belly syndrome?

Answer 34

Posterior urethral valves

Question 35

Prune belly syndrome is aka

Answer 35

Eagle - Barrett syndrome

Question 36

What is prune belly syndrome

Answer 36

Weakened abdominal wall musculature in conjunction with massively dilated ureters, bladder and kidneys

Question 37

Eagle-bennett syndrome is associated with —– bc of prolonged or severe oligo

Answer 37

Pulmonary hypoplasia

Question 38

Sono finds of prune belly syndrome

Answer 38

abnormal compression of the abd wall by fetal small parts
oligo
bilateral hydro and a massive distended urinary bladder

Question 39

The testis should descend into the scrotum at what gestation

Answer 39

between 26-34 weeks

Question 40

T or F, all hydroceles seen in utero are reason of concern

Answer 40

F, small hydroceles are common in utero, large ones warrant postnatal followup

Question 41

Term for when the urethra in a male fetus is not located at the tip of the penis

Answer 41

Hypospadias

Question 42

In this condition, the urethra does not develop into a full tube, and the urine exits the body from an abnormal location.

Answer 42

Epispadias

Question 43

Why would you seen ovarian cysts prenatally

Answer 43

Maternal hormone stimulation (should resolve after birth)