Duplex renal system is a rare congenital anomaly of the urinary tract that
can be diagnosed in utero. The purpose of this study was to establish the o
ptimal diagnostic criteria for fetal renal duplication in a population unde
rgoing prenatal sonographic screening. Between January 1989 and June 1997 w
e found 11 cases of duplex renal system, 10 of which were correctly identif
ied in utero at a median gestational age of 28 weeks (range, 20 to 38 weeks
), and one of which was a false-negative diagnosis. Prenatal diagnosis of d
uplex renal system can be made in utero during the second half of pregnancy
in the presence of two or more of the following signs: hydronephrosis limi
ted to one pole in a kidney with two separate, noncommunicating renal pelve
s; ipsilateral megaureter; and ureterocele.