ABSTRACT
OBJECTIVE: To describe the sonographic visualization of fetal micturition and its role in the diagnosis of posterior urethral valves and hypospadias. METHODS: This was a prospective study of 25 male fetuses (21 with bilateral pyelectasis, one whose bladder was being studied because of ureterocele and three with hypospadias), and five female fetuses (with bilateral pyelectasis). A midline sagittal scan of the fetal pelvis, perineum and external genitalia was obtained and observed continuously during fetal micturition. RESULTS: In 19 of the 21 male fetuses and the five female fetuses with bilateral pyelectasis micturition was normal, with visualization of urinary bladder contraction, slight fluid distention of the urethra and a urinary stream from the external urethral meatus. In three male fetuses, two with bilateral pyelectasis and the one with ureterocele, the posterior urethra was normal at rest and it ballooned out during micturition, diagnostic of posterior urethral valves. In the three male fetuses with hypospadias the ventral jet of the urinary stream was visualized. CONCLUSION: Fetal micturition can be visualized on sonography. It may be of value in the diagnosis of posterior urethral valves and hypospadias.
Subject(s)
Kidney Diseases/diagnostic imaging , Kidney Pelvis/diagnostic imaging , Ultrasonography, Prenatal/methods , Urethra/abnormalities , Urination/physiology , Dilatation, Pathologic/diagnostic imaging , Dilatation, Pathologic/embryology , Female , Humans , Kidney Diseases/embryology , Kidney Diseases/pathology , Male , Pregnancy , Prospective Studies , Ureterocele/diagnostic imaging , Ureterocele/embryology , Urethra/diagnostic imagingABSTRACT
We report the prenatal sonographic features of congenital bile duct dilatation associated with renal-hepatic-pancreatic dysplasia. The condition was seen at 22 weeks of gestation and led to termination of pregnancy. This is the first description of congenital bile duct dilatation using prenatal sonography. It is also the first report of a case in which the features of dysplasia were evident in all three of the organs which may be affected, the kidneys, liver and pancreas.
Subject(s)
Abnormalities, Multiple/diagnostic imaging , Caroli Disease/diagnostic imaging , Fetal Diseases/diagnostic imaging , Polycystic Kidney Diseases/diagnostic imaging , Abnormalities, Multiple/pathology , Adult , Caroli Disease/pathology , Female , Fetal Diseases/pathology , Humans , Liver/abnormalities , Liver/diagnostic imaging , Liver/embryology , Pancreatic Cyst/diagnostic imaging , Polycystic Kidney Diseases/pathology , Pregnancy , Syndrome , Ultrasonography, PrenatalABSTRACT
We report the prenatal diagnosis of total anomalous pulmonary venous connection to the portal system in a 20-week fetus with right atrial isomerism. The apex of the fetal heart pointed to the left, the fetal stomach was on the right, there was a common atrioventricular valve, the left ventricle was small and the abdominal aorta and inferior vena cava were on the left side; all these features were suggestive of right atrial isomerism. An anomalous vein was connected to the portal vein which ascended above the diaphragm and ended in a confluence of pulmonary veins, posterior to the common atrium. Color Doppler imaging helped confirm the diagnosis of total anomalous pulmonary venous connection. The prenatal findings were confirmed on autopsy.
