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2003-12-16-13 Answer to the case of the week #110 © Turner

Answer to case of the week #110

January 9-22, 2004

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

***Tennesse 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:

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:

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

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