LEARNING CENTER 2

29y primi with 9 months amenorrhoea referred to sonography with polyhydramnios.

On sonography scan fetus is 35 weeks. Brain, Spine, Stomach, skeletal system are normal.                 

Liquor is excessive. See the image. 

 Small bowel loops are dilated. See the image.

A well defined anechoic lesion behind the Urinary bladder in the rectal region.

With this images I gave report as ? Ano-rectal anomaly . Immediately discussed with referral doctor and requested to give feed back immediately.

Follow up :

After delivery baby is healthy.  Passed meconium as usually.

Discussion:  Incidence of polyhydramnios is 60% idiopathic.

                                                                   20% fetal causes

                                                                   20% maternal  causes.

                  Roughly degree of polyhydramnios correlates with site and severity of gut obstruction. Proximal the obstruction like oesophageal atresia more the polyhydramnios. Distal obstructions like imperforate anus may not produce polyhydramniosis.

Learning  : Lot of overlap between fetal gut physiology and pathology. So careful interpretation is mandatory.

Learning submitted by Dr. M.Adinarayana Rao. M.D.(Radio-diagnosis)

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