Hospital General de la S.S.A. Acapulco, Guerrero, Mexico. Departamento de Ultrasonido, Servicio de Ginecologia y Obstetrica, Dpto. de Cirugia Pediatrica.Facultad de Medicina de la Universidad Autonoma de Guerrero, Mexico. Instituto Mexicano de Diagnostico por Imagen, Acapulco, Mexico.

Case report
This is a case of a 28-year-old G3P2 with unremarkable personal and family history. The ultrasound scan at 25 weeks suggested a chromosomal anomaly. We performed an amniocentesis and the results confirmed our suspicion of trisomy 18.
The ultrasound findings at 37 weeks were following:

• Ventriculomegaly
• Micrognathia, flat nosal bridge
• Abnormal position of the thumbs
• Omphalocele
• Single umbilical artery
• Uretero-vesical junction obstruction, hydronephrosis, unilateral renal agenesis
• Ovarian cyst
• Ambiguous genitalia
• Sandal gap

Images 1: weeks, axial view of the brain, ventriculomegaly.

Images 2,3: Image 2 shows abnormal position of the thumb. Image 3 shows overlapping fingers.

Images 4-7: Omphalocele, single umbilical artery. Image 7 shows an ovarian cyst indicated by (*).

Images 8,9: Image 8 shows a dilated ureter due to an obstruction at the level of uretero-vesical junction. Image 9 shows hydronephrosis.

Images 10,11: Image 10 shows ambiguous genitalia. Image 11 shows a sandal gap foot.

Image 12: Profile of the neonate, note the flat nasal bridge and micrognathia.

Images 13,14: Hands with abnormal position of the thumb and overlapping fingers.

Images 15,16: Image 15 shows sandal gap foot. Image 16 shows ambiguous genitalia.