A case in point of oligohydramnios
A 28-year-old woman presented at 18 weeks with a history of having delivered an infant with a severerenal abnormality that resulted in his death a few minutes after birth. She remembers her doctors feeling thatthe infant had a “cystic kidney problem” but the actualautopsy information was not available.
On examination, the amount of amniotic fluid was diminished, with the largestvertical pocket being 1 cm, a
small bladder was seen, but the kidneys were slightly enlarged (0.40 KC/AC ratio) and had a fluffy appearance.
We invited her back 2 weeks later and there was morepronounced oligo- hydramnios. The kidneys were more
enlarged and were uniformly bright. The fetal bladderdid not fill during the 40-minute examination.
We told her that the findings and her history werecompatible with the diagnosis of infantile polycystic kid-
ney disease and we painted a very bleak picture regarding the prognosis.
She continued her pregnancy and she temporarily waslost to follow-up, but later was admitted to the hospital
in active labor at 35 weeks. Two hours later she delivereda fetus with Potter facies who died after a few minutes
of pulmonary failure. An autopsy confirmed the diagnosis of infantile polycystic kidney disease and she was
counseled about a 25% chance of recurrence.