Fabrice Cuillier, MD ¹, Alessandri J.L., MD ², Michel J.L., MD ³

1. Dept of Obstetrics and Gynecology, Hôpital Félix Guyon, rue des Topazes, 97400 Saint-Denis, Reunion Island, France. Ph : 0262 90 55 22.
2. Service de Néonatologie, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France.
3. Service de chirurgie pédiatrique, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France.

This was a 40-year-old mother with no history of consanguinity. She had a dilated cardiomyopathy and took furosemic acid, Digoxin and Losartan (Cozaar°, angiotensin receptor antagonist). The first scan performed at 13 weeks was normal. At 21 weeks of gestation, a bilateral uretero-pyelic dilatation was discovered. The patient was lost to follow up until 36 weeks of gestation. A scan at that time revealed a normal left kidney with normal cortico-medullary differentiation. The right kidney was not well visualized and instead a cyst was seen. Another anechoic structure was noted in close vicnity to the left kidney. Both of these cystic structures were thought to be urinomas. Associated anhydramnios rendered the assessment of the rest of the fetal parts difficult.

Scan at 36 weeks demonstrating urinomas.

Scan demonstrating the male sex of the baby.

The baby was delivered by a C-section. Aspiration cytology of these cysts revealed urine. Another anomaly that was discovered postnatally was a ventricular septal defect (muscular). Both these anomalies [urinoma formation due to right obstructive uropathy and the interventricular defect] were attributed to the inatke of Losartan.