Case report:
This case refers to cystic fibrosis and meconium ileus at 35 weeks with abnormal intestinal dilatation discovered at 28 weeks. There is no familial consanguinity. The first ultrasonography was normal. The nuchal translucency was 1 mm (CRL = 62 mm). The triple test was 1/190. An amniocentesis was performed. The fetal karyotype was 46XY. The second fetal ultrasonography was normal (22 weeks).
At 28 weeks, ultrasound examination revealed an abnormal fetus, with moderate polyhydramnios, moderate ileal and jejunal dilatation (Image 1) with normal peristalsis. There was no pyelectasy. There were no other dysmorphologic signs of aneuploidy. There was no sign of meconium peritonitis. There was no sign of congenital infection. The maternal serological status did not show any sign of maternal infection (TORCH and Parvovirus B19). Our first hypothesis of diagnosis was congenital chloride or sodium diarrhea. But sodium and chloride level in amniotic fluid were normal (results from first amniocentesis).
At 32 weeks, the aspect of the intestinal dilatation changed. Low digestive obstruction was suspected (Image 2, 3), with important aggravation at 35 weeks (Image 4). Mesenteric artery and vein had a physiological position (Image 5). Fetal ears and face were normal. Corpus callosus was present (Image 6). The extremities were also normal. Sex was male with bilateral hydrocele (Image 7). Abdominal fetal MRI was performed (Image 8, 9).
Image 1: At 28 weeks and 29 weeks, moderate ileal and jejunal dilatation.