Question

A 22-year-old primigravida visits ANC OPD with 20 weeks POG. On examination uterine height reveals a 16-week size. USG shows reduced liquor. What will be the diagnosis ?

• A. Renal agenesis
• B. Fetal anemia
• C. Barter’s syndrome
• D. Liddle syndrome

Answer 1

The Correct Option is A

When a 22-year-old primigravida presents with 20 weeks of pregnancy but examination reveals a uterine size consistent with 16 weeks and ultrasound detects reduced amniotic fluid (oligohydramnios), the differential diagnosis should focus on conditions affecting the production or excretion of urine by the fetus. One primary cause of oligohydramnios is a renal abnormality in the fetus.

In this scenario, the diagnosis of renal agenesis is most plausible. Renal agenesis leads to decreased or absent production of fetal urine, which is a major component of amniotic fluid. Thus, reduced fetal urine leads to oligohydramnios.

Other options mentioned, such as fetal anemia, Barter’s syndrome, and Liddle syndrome, do not typically present with oligohydramnios and reduced uterine size. Fetal anemia often presents with hydrops fetalis, while Barter's and Liddle syndrome have different renal manifestations that do not primarily cause oligohydramnios. Therefore, among the options provided, renal agenesis is the most accurate diagnosis.