Bladder Exstrophy in a Female Fetus: Ultrasound and Autopsy Findings

Introduction: Bladder exstrophy (BE) is a congenital anomaly within the exstrophy-epispadias complex (EEC), characterized by a defect in the closure of the lower abdominal wall and bladder. Case report: A female fetus at 20 weeks + 2 days showed at ultrasound (US) a homogeneous echogenic mass with a lobulated surface, protruding from the anterior lower abdominal wall. The bladder was not visualized. Doppler US displayed umbilical arteries laterally to the mass. The kidneys appeared normal. Amniotic fluid was regular. Legal termination of pregnancy occurred at 21 weeks + 4 days. Autopsy grossly and histologically confirmed BE. Microscopically, BE was layered by an urothelial-like epithelial layer and underneath, the muscularis propria was disarrayed with scarce nerve fibers, evidenced by immunohistochemistry for S-100. Conclusion: In case of prenatal diagnosis of BE, multidisciplinary counseling is mandatory for appropriate clinical management.