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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Etiology/Pathophysiology:
Causes of fetal anuria and oligohydramnios include renal agenesis,
renal cystic disease, and obstructive uropathy in the form of
posterior urethral valves. The decreased amniotic fluid causes
extrathoracic compression of the thorax and leads to development of
pulmonary hypoplasia. Pulmonary hypoplasia is frequently complicated
by spontaneous pneumothorax or pneumomediastinum due to
overdistension of small lungs with deficient alveoli that leads to
rupture of terminal airways and dissection of air into the
mediastinum or pleural space.
Pathology:
Have a diminished number of peripheral alveoli and pulmonary vessels
and the muscular layers of the pulmonary arteries are thickened
resulting in pulmonary hypertension and persistent fetal circulation.
Imaging Findings:
Small, hypoplastic lungs. Narrowed and constricted thoracic cage with
short, dysplastic ribs. Pneumothorax and related air leak
complications are common.
Renal ultrasound will demonstrate the
renal anomaly causing the oligohydramnios.
DDX:
References:
See References Chapter.
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