OBGY Radiology

Case 3 :
History : Mother shows poor weight gain. On ultrasound- evidence of IUGR (symmetric). Sonographic gestational age is 31 weeks.
Q- 1) a cystic structure seen floating in amniotic fluid: what is it?
Q-2) also keyhole appearance of urinary bladder- what is the diagnosis?
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1) Pseudocyst of the umbilical cord. This is a Wharton's jelly deposit within the umbilical cord, giving the appearance of a cyst. The cyst is seen close to loops of umbilical cord with a thin wall.
It is associated with a number of congenital anomalies of the fetus, especially if present in the 2nd or 3rd trimester (References: Sepulveda and others, Obstet Gynecol 1999 Mar).

2) Associated anomaly: Bladder shows distention and poor emptying with dilated posterior urethra. This suggests posterior urethral valve.(Label 1 : dilated posterior urethra, Label 2 :urinary bladder )
This fetus was delivered prematurely and survived only 2 hours. There were other anomalies of the limbs.

Contribution : Dr. Joe Antony, Cochin, Kerala