EP17.11: Oligohydramnios with multiple cysts of bilateral fetal kidneys during pregnancy without evidence of pulmonary hypoplasia after birth: a case report
Bibliographic record
Abstract
Fetal bilateral multicystic dysplastic kidney (MCDK) may be accompanied by oligohydramnios and pulmonary hypoplasia leading to poor postnatal prognosis. We report our experience with a case of severe oligohydramnios with multiple cysts in the bilateral kidneys but no evidence of postnatal pulmonary hypoplasia and good prognosis immediately after delivery. She was the 22-year-old primigravid woman with natural pregnancy and no particular medical or family history. At 25 weeks of gestation, fetal ultrasound revealed oligohydramnios, bilateral renal enlargement, and multilocular cysts with urine retention in the bladder but no other morphological abnormalities. Magnetic resonance imaging at 26 weeks of gestation showed similar findings in the fetal kidneys; therefore, pulmonary hypoplasia and polycystic kidney disease or MCDK were suspected. Findings during the subsequent clinical course showed additional reduction in the amniotic fluid volume. Although the amniotic fluid index (AFI) was virtually impossible to measure, urine retention was noted in the bladder. At this point in time, we explained that the condition was not considered fatal as the urinary bladder was visible in the images. At 38 weeks of gestation, labour was induced, and vaginal delivery was performed. The newborn was treated with mask CPAP because of retractive breathing at birth and admitted to the NICU. Chromosomal tests performed after birth revealed a normal karyotype. Ultrasonoscopy, renal scintigraphy revealed MCDK in the left kidney; however, the right kidney showed renal parenchymal structure, despite the number of cysts. A definitive diagnosis has not yet been determined. The present case demonstrated oligohydramnios with multiple renal cysts in the bilateral fetal kidneys; however, our observations show that if urine retention in the bladder, postnatal pulmonary hypoplasia may not develop and the prognosis immediately after birth could be good.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".