Question

A woman at 26 weeks of gestation presents for routine evaluation. On examination, fundal height corresponds to 24 weeks. Ultrasonography revealed decreased amniotic fluid. Which of the following conditions would have led to this presentation?

• A. Renal agenesis
• B. Tracheoesophageal fistula
• C. Cardiac abnormalities
• D. Ureteral stricture

Answer 1

The Correct Option is A

The situation described involves a woman at 26 weeks of gestation with a fundal height of 24 weeks and decreased amniotic fluid. This condition is known as oligohydramnios, which can occur due to several reasons, but in this scenario, we need to determine which specific condition can lead to this presentation.

The amniotic fluid is primarily produced by fetal urine in the second half of pregnancy. Therefore, any conditions affecting the fetal renal system can significantly impact the volume of amniotic fluid. Renal agenesis, which is the absence of one or both kidneys, directly results in a lack of fetal urine output, leading to oligohydramnios.

Let's examine the options:

• Renal agenesis: The absence of kidneys leads to no urine production, causing oligohydramnios.
• Tracheoesophageal fistula: This is an abnormal connection between the esophagus and trachea. Although it affects the ability to swallow amniotic fluid, it does not directly affect amniotic fluid production.
• Cardiac abnormalities: These can lead to other complications but are not directly associated with oligohydramnios.
• Ureteral stricture: This condition can affect urine drainage but not its production, so it typically does not cause oligohydramnios.

Among the given options, renal agenesis is the correct choice because it directly affects the production of amniotic fluid, causing oligohydramnios as observed in the ultrasound.