Antenatal Diagnosis of Bilateral Renal Agenesis in One of a Twin Pair
Bilateral renal agenesis (BRA) was diagnosed antenatally in one of like-sexed (probably monozygotic) twins. This is the first report of such a diagnosis. The difficulties of certain sonographic diagnosis of BRA are outlined and are possibly compounded in twin pregnancy in the presence of growth retardation/oligohydramnios of one of the twins. Recent evidence suggests that BRA is inherited in an autosomal dominant pattern with reduced penetrance and variable expressivity. The discordance for BRA in twins, even mono.zygotic twins, has been relatively frequent suggesting a possible role of environmental influences in the expression of the anomaly. Genetic counseling should include renal evaluation of asymptomatic parents and siblings and early detailed ultrasound evaluation of fetal kidneys in all subsequent pregnancies.
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