The single false-negative scan was of a patient first seen at 35 weeks' gestation with ventriculomegaly, and visualisation was affected by late gestation, supine fetal position and anhydramnios
due to bilateral renal pathology.
Indications for CD included fetal distress (n=7), breech presentation (n=5), anhydramnios
(n=3), failed induction of labour (n=3), previous CD x1 (n=4), previous CD x2 (n=2), poor progress of labour (n=2), cord prolapse (n=1), high parity (n=1) and very low fetal weight (n=1).
(22,26,34,60,64,65) Oligohydramnios or anhydramnios
, hydrops fetalis, pulmonary hypoplasia, cryptorchidism, and fetal death are also reported.
Absence of fetal urine production is known to result in oligohydramnios and anhydramnios
, causing fetal malformations described in Potter sequence including flattened facies, limb malformations, low set abnormal ears, and pulmonary hypoplasia.
The fetus was delivered by Caesarean section at 34 weeks because of IUGR; prior to delivery, trastuzumab was discontinued after 21 weeks of gestation because of anhydramnios
and nonvisualization of the fetal bladder.
A total of 4 patients had a termination of pregnancy, 3 for confirmed chromosomal abnormalities as detailed above, and 1 for spontaneous rupture of membranes and anhydramnios
at an early, non-viable gestation.
She had a past history of emergency caesarean section in 2011 at 35 weeks of gestation due to anhydramnios
and pregnancy induced hypertension.
Ultrasound features are early anhydramnios
from 16 weeks of gestation onwards, absence of bladder filling, and empty lumbar fossae.
Also, oligohydramnios and anhydramnios
were seen in two fetuses.
Of the 10 fetuses with follow-up data, the option of termination was offered in 6 cases of anhydramnios
, including 3 cases with signs of infravesical obstruction (a possible posterior urethral valve (PUV) and poor prognostic factors and 3 cases with unilateral hydronephrosis and increased echogenicity in the contralateral kidney.
Oligohydramnios or anhydramnios
were present in 7 growth restricted foetuses.
Terminated cases, because of associated severe / lethal extra-cardiac pathologies (Group A) Pathological classification n = 39 Clinical diagnosis (n) Chromosomal pathologies 23 Trisomy 21 (n=13), trisomy 18 (n=8), trisomy 13 (n=2) Genitourinary pathologies 6 Bilateral renal agenesis (n=2), multicystic dysplastic kidneys associated with oligo- / anhydramnios
(n=4) Central nervous system 7 Anencephaly (n=1), pathologies holoprosencephaly (n=2), hemivertebra (n=l), vermis agenesis (n=1), neural tube defect (n=2) Other 3 Severe generalized hydrops / septated cystic hygroma (n=3) Table 3.