Fetal megaureters masquerading as bowel obstruction

As a result of repeated ultrasound assessments for determination of gestational age, more congenital anomalies are detected in the fetus. Early diagnosis has serious implications for both mother and fetus. We present our experience in the management of a male fetus with obstructive uropathy diagnosed at seventeen weeks of gestation. In serial ultrasounds the tortuous megaureters were mistaken for distended loops of bowel. When the question of obstructive uropathy is raised, and the bladder cannot be visualized, administration of diuretics to the mother may promote fetal bladder filling. Since the advent of intrauterine surgical intervention, distinguishing between megaureters and obstructive bowel disease may have important clinical implications.