eISSN: 2449-6731
ISSN: 2449-6723
Prenatal Cardiology
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Case report

Extraordinary bulging mass in the foetus - a case report of bladder exstrophy

Joanna Łosińska
Maria Respondek-Liberska
2, 3

  1. Student of the Medical Univerisity of Lodz
  2. Department of Prenatal Cardiology Polish Mother's Memorial Hospital Research Institute. Lodz, Poland
  3. Department of Diagnosis and Prevention of Fetal Malformations, Medical University, Lodz, Poland
Prenat Cardio 2018 Jan; 8(1):48-52
Online publish date: 2019/07/16
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Prenatal diagnosis of bladder exstrophy is extremely rare and difficult.

Due to abnormal development of the cloacal membrane there is an incomplete closure of the lower abdominal wall, absence of the anterior wall of the bladder and external exposition of the posterior wall. The pubic bones are usually separated, the umbilical cord low inserted and there is abnormal external genitalia development

Case Report
At 21st week of gestation of 39-year-old multigravida multipara referred by a primary care obstetrician to high-specialised centre for a detailed ultrasound examination with a suspicion of bladder absence and inferior umbilical localisation. At 29 weeks of gestation presence of bulging mass of 2 cm, between the umbilical outlet and labia was detected. At 31 weeks of gestation previously detected structure among thighs had 3 cm diameter with lateral umbilical outlet. Major labia were prominent and minor labia were within normal limits. Between two umbilical arteries with an appropriate intraabdominal course there were no transsonic area corresponding to the urinary bladder. The newborn baby was born at term in a good condition, but with an exposed bladder of 4 cm in diameter. The urethral outlet was not visualised and the female genitals were abnormal. After a month the girl underwent primary bladder exstrophy closure. Although she suffers from recurring urinary tract infections, she is in a good general condition.

Due to prenatal diagnostics it was possible to detect and make an initial diagnosis of severe malformation. Early diagnosis allowed to prepare parents for a newborn with a defect and teach them how to take care of the baby.


bladder exstrophy, prenatal diagnosis, ultrasound examination

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