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Oligohydramnios

Frank H Miller, MD
Faye C Laing, MD

June 8, 1994

Presentation

In this 1984 case, patient is small for dates.

Imaging Findings

Ultrasound Examination

Ultrasound examination shows anhydramnios. Scans of the renal fossae (arrows) fail to demonstrate the kidneys and bladder.

Diagnosis

Absent amniotic fluid due to renal agenesis

Discussion

Profound oligohydramnios may result from fetal urinary tract anomalies that include bilateral renal agenesis, posterior urethral valves, and bilateral multicystic dysplastic kidneys. Nonrenal etiologies include intrauterine growth retardation, post-term pregnancy, fetal demise, and ruptured membranes. Due to the lack of amniotic fluid, the lungs are hypoplastic and neonates who survive delivery die of respiratory failure. Severe and prolonged oligohydramnios leads to a constellation of findings that include Potter's facies (flattened nose, recessed chin, and low-set ears) and positional abnormalities (clubbed feet, dislocated hips, and contractures).

Bilateral renal agenesis is a result of absence or failure of development of the ureteric bud and occurs in approximately 1 in 4,000 births. The inability to produce urine results in severe oligohydromnios and nonvisualization of the bladder. Absence of the kidney may be difficult to diagnose due to severe oligohydramnios. A normal bladder excludes the diagnosis. Bilateral renal agenesis is incompatible with life.

References

1. Dubbins PA, Kurtz AB, Wapner RJ, et al. Renal agenesis: Spectrum of in utero findings. J Clin Ultrasound 1981;9:189-193.

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