Prenatal diagnosis of multicystic dysplastic kidney with contralateral pelviureteric junction obstruction on ultrasound

A 24-year-old primigravida from a rural background presented to the hospital at 18 weeks of gestation and was referred for anomaly scan. This is the first antenatal scan for which the patient presented. Longitudinal ultrasound revealed irregular outline of the left kidney with multiple thin-walled cysts demonstrating no obvious communication with the pelvicalyceal system (Figure 1). Incidentally, right kidney shows pelviureteric junction obstruction with hydronephrosis (Figure 2). Ultrasound revealed normal fetal movements and fetal heart sounds. Fetal parameters were within normal limits. The amniotic fluid index was decreased at 6 cm. 1 An ultrasound diagnosis of left-sided multicystic dysplastic kidney (classic/pelvi-infundibular type) and contralateral pelviureteric junction obstruction with hydronephrosis was made. Prenatal diagnosis was confirmed on post-natal ultrasound. On post-natal day 3, the baby was referred to the department of pediatric nephrology for further management. Multicystic dysplastic kidney (MCDK) is a severe anomaly with grave prognosis which results in non-functioning kidneys. 2 Most common associated anomalies of MCDK on the contralateral side include ure-teropelvic junction obstruction, as noted in the current case, or vesi-coureteral reflux which may be prevalent in 30% – 40% of cases. 3 The characteristic findings