Urethral agenesis, 13th week

Marcos Antonio Velasco Sanchez, MD, Carlos Robles Garcia, MD, Candelairo Conda Moreno, MD, Hilario Bibiano Pano, MD

Clinica Medica de Jesus, Pinotepa Nacional Oaxaca, Mexico. Hospital General de la S.S.A. Acapulco, Guerrero, Mexico. Instituto Mexicano de Diagnostico por Imagen. Facultad de Medicina (Division de Posgrado) de la Universidad Autonoma de Guerrero, Mexico.

This is a 23-year-old woman, with unremarkable past obstetrical history, scanned at 13th week of gestational age. The ultrasound revealed: cystic hygroma; massively dilated urinary bladder with distend abdominal wall and compressed thorax.. The findings were consistent with urethral obstruction - agenesis. Due to early pregnancy scan the amniotic fluid volume was still normal. Postnatal investigation confirmed urethral agenesis and cystic hygroma. Karyotype was normal (46, XY).

Images 1, 2. Sagittal (left) and coronal (right) planes showing dilated urinary bladder.

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Images 3, 4. Coronal plane throughout fetal neck showing cystic hygroma (left); and abnormal ductus venosus waveform (right).

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Images 5, 6. 3D images showing dilated urinary bladder and cystic hygroma of the fetus.

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Images 7, 8. Pathological specimens showing cystic hygroma (left); and distended abdomen (right).

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Images 9, 10. Pathological specimens showing dilated urinary bladder (left); and normal appearance of the kidneys (right).

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