A 23-year-old G1 P0 with non-contributive family or personal history from consanguineous marriage, was scanned repeatedly for severely decreased amount of the amniotic fluid.

Ultrasound examination at 21 weeks of gestation showed severe oligohydramnios. Both kidneys and urinary bladder could not be visualized. Subsequent ultrasound examinations at 24, 27 and 31 weeks of gestation confirmed the previous findings. Our diagnosis was bilateral renal agenesis.

The ultrasound performed at 35 weeks of gestation, at the day of delivery, showed the same findings. The fetus had a small chest with hypoplastic lungs, both kidneys and bladder could not be visualized.There was a severe oligo - anhydramnios.

The neonate was delivered vaginally, weighted 1420 grams with Apgar scores 4 /6 /8 (in 1st / 5th /10th minute). The postnatal ultrasound confirmed bilateral renal agenesis. The condition of the neonate deteriorated quickly and died 15 hours after delivery due to pulmonary hypoplasia and metabolic complications due to renal agenesis.

Images 1,2: Image 1 shows abdominal aorta and bifurcation, note absence of the renal arteries. Image 2 shows abdominal circumference, note absence of the amniotic fluid around the abdomen.

Images 3,4: Doppler imaging of the umbilical cord, note the absence of the amniotic fluid pocket.

Images 5,6: Image 5 shows the neonate after delivery, note the abnormal position of the legs caused by oligohydramnios. Image 6 shows the chest X-ray taken after delivery.