Obstetric Cortical Necrosis Recovery Prognosis — ESENeph MCQ

Correct answer: B — Renal cortical necrosis following severe prolonged obstetric hypoperfusion

The best answer is “Renal cortical necrosis following severe prolonged obstetric hypoperfusion”. Severe obstetric shock can cause cortical ischaemic necrosis. Complete disease has poor recovery, while patchy involvement can permit delayed partial recovery; follow-up should not assume either outcome prematurely. “Bilateral renal-vein thrombosis causing renal congestion and haematuria” is less appropriate because the cortical non-enhancement after profound haemorrhage supports diffuse cortical ischaemia “Acute interstitial nephritis causing pyuria and tubular dysfunction” is less appropriate because there is no drug-allergy phenotype and imaging pattern is different “Minimal-change disease causing nephrotic proteinuria and preserved renal structure” is less appropriate because this causes nephrotic syndrome rather than cortical non-perfusion “Postpartum physiological change causing a small transient creatinine variation” is less appropriate because dialysis-requiring AKI and imaging are pathological

Reference: UK Kidney Association pregnancy and renal disease guideline: https://www.ukkidney.org/health-professionals/guidelines/pregnancy-and-renal-disease