Presentation
Routine obstetric ultrasound scan. Fetal gestational age 19 weeks.
Patient Data
Ultrasound reveals distended urinary bladder with keyhole sign, dilated ureters due to reflux, severe hydronephrosis, and oligohydramnios.
Case Discussion
Posterior urethral valves (PUV) is a congenital abnormality that is characterized by membranous folds found in the lumen of the posterior urethra and lead to bladder outlet obstruction.
This patient come to the hospital fora routine obstetric scan. Fetal gestational age was 19 weeks.
Here are some features observed in this fetus and suggested urethral valves:
dilated bladder: due to the obstruction of urine flow. This can be visualized as a round, fluid-filled structure in the lower abdomen
keyhole sign: The urethra may appear as a keyhole-shaped structure, indicating dilated proximal urethra
hydronephrosis: This occurs because urine backs up into the kidneys when the flow is obstructed
oligohydramnios: is presented due to impaired fetal urine production and circulation
While ultrasound is the modality of choice for imaging patient with posterior urethral valve, another imaging techniques may be requested to confirm especially after birth like voiding cystourethrogram (VCUG).
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