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Fetal Aneuploidy Screening Mastery

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Renal Pyelectasis

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This session covers mild dilation of the fetal renal pelvis. Students will learn the measurement thresholds for pyelectasis in the second trimester and understand when this isolated finding warrants follow-up or genetic counseling.

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Complete this lesson and pass the quiz to earn 10 Karma Points and move one step closer to your Fetal Aneuploidy Screening Mastery Certification.

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1. How is fetal renal pyelectasis defined, and which dimension of the renal pelvis must be measured to assess it?
Enlargement of the renal cortex, measured in the longitudinal dimension Dilatation of the renal pelvis, measured in the anteroposterior dimension Dilatation of the renal calyces, measured in the transverse dimension Renal pelvic dilatation, measured in the coronal dimension
2. What is the correct transducer alignment when measuring the anteroposterior diameter of the renal pelvis for pyelectasis assessment?
The transducer is held longitudinally along the fetal spine Transducer is aligned transversely across the fetal abdomen (ant. fetal spine) The transducer is aligned in a coronal plane through the kidneys Any plane is acceptable as long as both kidneys are visualised
3. What anteroposterior diameter threshold is most commonly used to define significant renal pyelectasis on prenatal ultrasound?
Greater than 1 mm Greater than 2 mm 3 to 4 mm Greater than 5 mm
4. Renal pyelectasis is associated with an increased incidence of which specific chromosomal aneuploidy?
Trisomy 18 Trisomy 13 Trisomy 21 Monosomy X
5. What is the reported prevalence of moderate pyelectasis in chromosomally and structurally normal fetuses, and what is its expected natural history?
Less than 1% and it always persists 2% to 2.8%, with most cases resolving as pregnancy progresses 5% to 7%, with resolution in the third trimester only 10%, with resolution at birth
6. In a low-risk patient, isolated fetal renal pyelectasis with no additional soft markers or structural anomalies — what is the appropriate management?
Immediate amniocentesis regardless of other findings Referral for fetal echocardiography Amniocentesis is NOT warranted for isolated pyelectasis in a low-risk patient Repeat ultrasound at 28 weeks only, without further workup
7. In high-risk patients, with which other second-trimester soft markers is renal pyelectasis combined to refine aneuploidy risk assessment?
Choroid plexus cysts and echogenic intracardiac focus Nuchal fold thickness and short femur or humerus length Absent nasal bone and sandal gap Echogenic bowel and ventriculomegaly
8. In a high-risk maternal population, what is the clinical significance of detecting renal pyelectasis as a solitary soft marker finding?
It has no independent significance and should be disregarded It alone may increase the incidence of fetal Trisomy 21 It mandates immediate amniocentesis regardless of other markers It is only significant if bilateral