Dr. To Nguyen Ha presents a comprehensive approach to bilateral hyperechogenic kidney diagnosis, explaining this common fetal finding that affects 1.6 per 1000 pregnancies and creates counseling challenges due to diverse underlying causes.
The webinar begins by establishing normal fetal kidney development. Hyperechogenic kidney appears brighter than liver or spleen after 17 weeks, but understanding normal echogenicity changes is crucial since fetal kidneys naturally appear hyperechoic early in pregnancy. Corticomedullary differentiation becomes visible around 15–16 weeks, and its presence or absence provides important diagnostic information.
Dr. Ha systematically categorizes hyperechogenic kidney causes into genetic and non-genetic etiologies. Most cases are non-isolated, with genetic causes including chromosomal abnormalities, copy number variants, and single gene disorders being increasingly recognized through advanced molecular testing.
The presentation details major genetic conditions. Autosomal dominant polycystic kidney disease typically shows moderately enlarged kidneys with preserved differentiation and positive family history. In contrast, autosomal recessive polycystic kidney disease presents with massively enlarged kidneys and poor prognosis. Various syndromic conditions like Meckel–Gruber syndrome combine hyperechogenic kidney with other anomalies including encephalocele and polydactyly.
Non-genetic causes discussed include obstructive uropathy and cytomegalovirus infection, which directly affects renal tubules causing increased echogenicity.
The webinar emphasizes systematic prenatal diagnosis approaches including detailed anatomical assessment, amniotic fluid evaluation, and parental screening. Genetic testing protocols progress from chromosomal microarray to molecular analysis based on clinical findings.
Dr. Ha concludes by discussing prognostic factors, emphasizing that outcomes range from normal kidney function to perinatal death depending on underlying etiology, kidney size, and associated oligohydramnios. The presentation provides practical guidance for clinicians managing this challenging diagnostic scenario.
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