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Pathology
A 20-year-old primigravid woman is in the third trimester and has felt minimal fetal movement. An ultrasound scan shows bilaterally enlarged echogenic kidneys and a markedly decreased amniotic fluid index. She gives birth to a stillborn male fetus at 33 weeks' gestation. At autopsy, there are deformations resulting from marked oligohydramnios, including flattening of the facies, varus deformities of the feet, and marked pulmonary hypoplasia. Microscopic examination of the liver shows multiple epithelium-lined cysts and proliferation of bile ducts. Which of the following is the most likely renal disease in this fetus?
Autosomal dominant polycystic kidney disease
Autosomal recessive polycystic kidney disease
Medullary sponge kidney
Multi-cystic renal dysplasia
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