Case of the Week # 110

Cheryl Turner, RDMS, BS***, Sefa Kelekci, MD*, Jos Offermans, MD, PhD**, Philippe Jeanty, MD, PhD***

January 9-22, 2004

***Tennessee Women's Care, Nashville TN, * Suleymaniye Maternity Hospital, Department of Perinatology, Istanbul, Turkey, **Dept of Ob-Gyn, Academic Hospital Maastricht.

This second trimester was performed for routine assessment of fetal anomalies in a patient with unremarkable history:

case0110-a
case0110-b
case0110-c
case0110-d
case0110-e
case0110-f
case0110-g
case0110-h
case0110-i
case0110-j
case0110-k
case0110-l
case0110-m
case0110-n
case0110-o
case0110-p
case0110-q

View the Answer Hide the Answer

Answer

This second trimester was performed for routine assessment of fetal anomalies in a patient with unremarkable history:

case0110-a
case0110-b
case0110-c
case0110-d
case0110-e
case0110-f
case0110-g
case0110-h
case0110-i
case0110-j
case0110-k
case0110-l
case0110-m
case0110-n
case0110-o
case0110-p
case0110-q

The finding is this case is an enormous cystic collection that displaces and deforms the fetus. Further, there is no amniotic fluid. This combination points to a major obstruction of the bladder outlet. Several conditions can cause that such as posterior urethral valve, Urethral meatus agenesis but these usually present with some amniotic fluid. So a more severe condition like Urethral agenesis was suspected. The patient elected to terminate the pregnancy in view of the dismal prognosis and after a drainage tap of the bladder the fetus was delivered:

IMG_3138
IMG_3140
IMG_3141
IMG_3142
IMG_3143
IMG_3144
IMG_3145
IMG_3146

The pathology confirmed the ultrasound findings (note the absence of external genitalia which is common).

Discussion Board

Start a discussion about this case
Add to Favorites Favorite

Menu