Prenatal sonographic diagnosis of VATER association.
OBJECTIVE
We examined the potential role of sonography in the prenatal diagnosis of the VATER association, a spectrum of fetal anomalies that includes vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia.


METHODS
The sonographic findings in 4 fetuses with prenatal diagnoses of VATER association were prospectively recorded, along with information on outcome and postnatal radiographic findings.


RESULTS
VATER association was diagnosed in 4 fetuses at 20, 17, 21, and 29 weeks' menstrual age. All showed bilateral radial atresia and tracheoesophageal fistula, visible sonographically as a collapsed or absent stomach with polyhydramnios. Two fetuses had vertebral defects. Postnatal radiographic and macroscopic findings confirmed the prenatal diagnosis in all cases. Other associated anomalies detected prenatally included single umbilical arteries (2 cases), ventricular septal defect (1 case), and renal abnormalities (2 cases). Anal atresia, present in 3 of the 4 fetuses, was not detected prenatally.


CONCLUSIONS
This small series suggests that the VATER association can be readily diagnosed in utero. Important clues include radial atresia, absent or collapsed stomach, and polyhydramnios. Prenatal diagnosis can contribute to clinical decisions regarding pregnancy and neonatal management.
Tongsong
T
T
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Wanapirak
C
C
Piyamongkol
W
W
Sudasana
J
J
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging* / Q000401:mortality; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D006831:Polyhydramnios / Q000000981:diagnostic imaging; D011247:Pregnancy; D011379:Prognosis; D011884:Radius / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging*; D013270:Stomach / Q000002:abnormalities / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal