Left-sided multicystic renal dysplasia. Prenatal ultrasound diagnosis and genetic counseling. Clinic case report

Abstract

Multicystic renal dysplasia is a common renal anomaly and the second cause of palpable renal mass in the newborn after hydronephrosis. Its prognosis and treatment are controversial depending on whether one or both kidneys are involved. The advent of prenatal ultrasonographic diagnosis for subsequent genetic counseling for couples has shed light on the subject. A clinical case of prenatal diagnosis of left unilateral multicystic renal dysplasia in the municipality of Colon, province of Matanzas, and the entire process of genetic counseling to the couple from the prenatal stage until birth. Data from the Cuban Registry of Prenatal Diagnosis of Congenital Defects were used and ethical considerations were taken into account. The diagnostic suspicion was established at 22.6 weeks of gestation and confirmed at secondary and tertiary levels of health care, followed by personalized genetic counseling and a non-directive, evidence-based approach to the couple who opted for the continuity of pregnancy. The case was managed by a multidisciplinary team during the third trimester and delivery. A male product was obtained at 39 weeks, and the congenital defect, that has had favorable clinical evolution, was verified. It is concluded that multicystic renal dysplasia is potentially diagnosable prenatally and the unilateral variety can achieve a good prognosis. Providing accurate information and integrating the couple's family and cultural context for decision making is the cornerstone of genetic counseling.