title: Enlarged fetal bladder: Differential diagnosis and outcomes.
abstract: The sonographic finding of an enlarged fetal bladder may simply be a transitory normal variant, but it may also be secondary to reflux or to obstructive, neurogenic, or myopathic causes. In this report, we describe the cases of 3 fetuses with an enlarged bladder, each of which had a different cause. The first fetus had posterior urethral valve obstruction, the second, a ruptured neurogenic bladder, and the third, megacystic-microcolon-intestinal hypoperistalsis syndrome. When sonographic examination reveals an enlarged fetal bladder, the ureter, kidneys, genitalia, and spine should be evaluated carefully. Although sonography is good at identifying urinary tract abnormalities, it often cannot provide the specific diagnosis or cause. We recommend frequent sonographic monitoring to evaluate such fetuses for persistence of or changes in bladder enlargement and for changes in the volume of amniotic fluid because these signs may be indicators of abnormalities of renal function and risk factors for a poor prognosis. Analysis of fetal electrolyte levels can also aid in determining the prognosis and whether the condition is amenable to therapeutic intervention.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Maine Medical Center, 887 Congress Street, Suite 200, Portland, Maine 04102, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Pinette
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Blackstone
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Wax
authors.forename: Angelina
authors.initials: A
authors.lastname: Cartin
mesh_terms: D000328:Adult; D003106:Colon / Q000002:abnormalities / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D007422:Intestines / Q000002:abnormalities / Q000000981:diagnostic imaging; D010528:Peristalsis; D011247:Pregnancy; D012422:Rupture, Spontaneous; D016216:Ultrasonography, Prenatal; D014524:Urethral Obstruction / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000002:abnormalities / Q000000981:diagnostic imaging*; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging