What are the differential diagnoses for fetal bladder distension (hydronephrosis)?

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Differential Diagnosis of Fetal Bladder Distention

Single Most Likely Diagnosis

  • Posterior Urethral Valves (PUV): This condition is the most common cause of fetal bladder distention, particularly in male fetuses. PUVs are obstructive membranes in the posterior urethra that impede the normal flow of urine, leading to bladder distention and potential renal impairment.

Other Likely Diagnoses

  • Urethral Atresia: A congenital anomaly where the urethra is partially or completely blocked, preventing normal urine flow and causing bladder distention.
  • Prune Belly Syndrome: A rare congenital disorder characterized by the absence or severe weakness of the abdominal muscles, undescended testes, and urinary tract anomalies, including bladder distention.
  • Megacystis: A condition where the fetal bladder is significantly enlarged, often due to obstructive uropathy or neurogenic bladder.

Do Not Miss Diagnoses

  • Spinal Dysraphism: Congenital anomalies of the spine, such as spina bifida, can cause neurogenic bladder leading to bladder distention. Early detection is crucial for proper management and prevention of long-term complications.
  • Eagle-Barrett Syndrome (Prune Belly Syndrome variant): Although rare, this condition can have a significant impact on fetal and neonatal outcomes, making it essential to consider in the differential diagnosis.

Rare Diagnoses

  • Ureterocele: A congenital anomaly where the ureter balloons into the bladder, potentially causing obstruction and bladder distention.
  • Bladder Exstrophy: A rare congenital defect where the bladder is open and exposed, often associated with other genitourinary and musculoskeletal anomalies.
  • Cloacal Exstrophy: A rare and complex congenital anomaly involving the genitourinary, gastrointestinal, and musculoskeletal systems, which can present with bladder distention among other findings.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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