The bladder is not visualized for 12 weeks. Pathology of the bladder in the fetus: what can be determined on screening ultrasound. The bladder in the fetus: the formation and its size by week

For a correct diagnosis, prescribing drug therapy and simply assessing the condition of the bladder, a urologist needs data from an ultrasound examination of the patient. But for the patient himself, the examination is no less important, because the bladder with normal echogenicity can also have hidden problems. In addition, only ultrasound of the bladder allows you to identify and eliminate pathologies in time, which cannot be detected without the help of ultrasound.

As part of the interpretation of the results of ultrasound diagnostics, several parameters that affect the diagnosis are of particular importance. Consider their normal and pathological characteristics.

Video 1. Bladder on ultrasound is normal.

The form

The shape of the urea is significantly influenced by the level of its filling, as well as the condition of the adjacent organs. Transverse images show us a rounded shape, and longitudinal images show an oval-shaped organ. The boundaries of a healthy bladder are visually defined as even and clear..

Features of the organ in women

In the fairer sex, the shape of the urea depends on whether the woman is pregnant at the time of the examination.

The bladder of a woman differs from that of a man in a shorter but wider shape, which must be taken into account by the diagnostician when deciphering the study data.

Structure

The normal structure of the bladder is echo-negative (anechoic) character, but with age, echogenicity increases. This is due to chronic inflammation, which leaves its mark on the state of the organ in elderly patients.

Volume

On average, the capacity of the urea in women is 100-200 ml less than in men, and ranges from 250 to 550 ml, (while the volume of the male bladder is 350-750 ml). In addition, the walls of the organ are able to stretch, therefore, in tall and large men, the volume of the bladder can reach 1 liter. (when filled).

Reference! The average urination rate is 50 ml/h.

Children's bladder has its own characteristics: its volume increases as the child grows. Age norms of bladder volume in healthy children:

• infants (up to 1 year old) - 35-50 ml;
• from 1 to 3 years - 50-70 ml;
• from 3 to 5 years - 70-90 ml;
• from 5 to 8 years - 100-150 ml;
• from 9 to 10 years - 200-270 ml;
• from 11 to 13 years - 300-350 ml.

If an increase or decrease in an organ is detected during ultrasound diagnostics, then a more detailed examination of a small patient is necessary to determine the causes of this phenomenon.

Bubble walls

Over the entire surface of the organ, its walls should be uniform, with a thickness of 2 to 4 mm (thickness is directly dependent on the degree of filling of the organ). If the doctor noticed on ultrasound a local thinning of the wall or its compaction, then this may be evidence of the onset of the pathology.

Residual urine

An important factor that must be studied during ultrasound is the amount of urine remaining in the bladder cavity after going to the toilet.

Normally, the residual urine should not exceed 10% of the total volume of the organ: on average, up to 50 ml.

How to calculate volume?

Usually, the measurement of bladder volume occurs during an ultrasound examination using a mobile ultrasound machine. The capacity of the organ can be calculated automatically: for this, the doctor needs to find out such parameters as the volume (V), width (B), length (L) and height (H) of the bladder.

For calculation is used formula V=0.75хВхLхН

What are they watching?

During an ultrasound examination of the bladder, among other things, pay attention to:

• hematuria (the presence of blood particles in the urine, especially in children);
• sperm in the urine of male patients (this may mean the contents of the gonads are thrown into the urea).

Pathologies

When deciphering the ultrasound data, serious deviations can be detected, which must be immediately treated to avoid complications.

Sediment in the urine (flakes and suspension)

In the analysis of urine or during ultrasound of the bladder, the patient may find flakes and suspensions, which are a mixture of different cells (erythrocytes, leukocytes or epithelial cells). Cells from the walls of the urethra can enter the urea, and this does not indicate pathology. However, sediment in the urine may also indicate the development of certain diseases, such as:

• pyelonephritis (inflammation, often of a bacterial nature);
• nephrosis (a whole group of kidney diseases);
• cystitis (inflammatory disease of the bladder);
• glomerulonephritis (damage to the renal glomeruli);
• tuberculosis (the cause of this serious infectious disease is Koch's wand);
• urethritis (inflammatory process in the urethra);
• renal dystrophy (pathology with the formation of fat inside the kidney structures);
• urolithiasis (in the urinary system, the formation of sand and stones, i.e. stones);
• diabetes mellitus - characterized by a lack of insulin and affects many body systems, including the urinary tract.

The inflammatory process in the bladder is called "cystitis".

Important! The acute form of the disease is characterized by a sharp deterioration in the quality of life: the patient experiences frequent urge to urinate, which becomes painful, and relief comes only for a very short time.

In the chronic form of the disease, ultrasound makes it possible to see a thickening of the walls of the bladder, as well as a sediment at the bottom of the organ. In details .

Cancer

Can cancer be seen on ultrasound? If the attending physician suspects the development of an oncological process, he will recommend undergoing a transabdominal ultrasound examination, as the most comfortable and meaningful. It is it that will make it possible not only to determine the presence of a tumor, but also to assess the degree of its spread, as well as the size and structural features.

Ultrasound allows you to assess:

• bladder capacity;
• the clarity of its contours;
• wall infiltration;
• the exit of the neoplasm outside the organ;
• type of growth and form of the tumor;
• regional metastasis;
• status of nearby lymph nodes.

Enlarged lymph nodes do not always mean their metastasis- it can be the result of a variety of processes: from a banal scratch to inflammation in adjacent areas.

On ultrasound, you can see and assess the condition of the upper urinary tract, clarifying the presence of dilation of the ureter and kidneys. The fact is that the cavitary system of the ureter and kidneys can expand due to oncological lesions of the mouth of the ureter, or damage to the urinary tract. However, the main indicator here will be the determination of the stage of the disease., and the listed features will be determined a second time.

Reference! With a tumor size of more than 5 mm, the ultrasound diagnostic method is highly accurate. However, with very small tumor sizes or a flat form of formation, there is a possibility of false negative results.

If doubts remain after the study, it is better to supplement the diagnosis with intracavitary ultrasound techniques (for example, transvaginal or transrectal).

Polyp

The term “polyp” in medicine refers to a benign formation that protrudes into the cavity of an organ. It can be located both on a wide base and on a small and thin leg.

If the polyp is located in the cavity of the bladder, then it is important to evaluate its shape, size and exact location.

neurogenic dysfunction

With neurogenic disorders of the bladder, the doctor will not see any specific picture on the screen of the ultrasound machine. The changes will be similar to the signs observed with infravesical obstruction, that is, it will be found:

• change in the shape of the organ, its asymmetry;
• trabecularity and wall thickening;
• diverticula;
• stones and sediment in the urinary tract.

A sac-like protrusion in the wall of the bladder is medically known as a "diverticulum" (see image on the right).

It communicates with the main cavity with the help of a neck - a special channel.

With this pathology, echographic scanning of the organ is mandatory.

It will help to assess the location, size and shape of the diverticulum, the length of its neck and relation to adjacent tissues and organs.

If a diverticulum is identified, urodynamic studies (cystometry or uroflowmetry) are required to assess bladder outlet obstruction.

blood clots

Sonographically, blood clots can be defined as irregularly shaped masses with increased echogenicity. Rarely have a round or semicircular shape. They are also characterized by heterogeneous echogenicity and jagged edges, may have hypoechoic inclusions, shaped like foci or layered stripes (this is caused by the layering of the clot).

Only in the presence of a persistent sediment formed from blood particles and epithelium can a relative echogenic homogeneity of the clot be observed.

Important! If the patient during the examination changes the position of the body, and the formation in the bladder moves with him, then this indicates the presence of a clot. But if the clot remains near the wall of the organ, then it is very difficult to differentiate it from the tumor.

Stones in the cavity

Stones (the second name for stones) in the bladder are no different from similar formations in the kidneys or gallbladder. All of them are high-density structures that do not conduct echo beams. That is why they are visualized on the device screen as white formations with dark paths of acoustic shadow behind.

A distinctive feature of the stones is mobility. Unlike tumors, they are not attached to the walls of the organ, so they easily change their position when the patient moves. This sign is the basis for reliable separation of the stone from the tumor during the diagnosis.(the latter will not change its position, as it is fixed in the tissue of the organ).

What else can be seen?

Ultrasound examination of the bladder can detect the following phenomena.

Some women may experience unpleasant symptoms during pregnancy, indicating that the uterus has begun to put pressure on the bladder. In this case, the patient very often visits the toilet and feels pain in the lower abdomen. Let's see why this happens.

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Possibility of uterine pressure on the bladder

During pregnancy, the genitourinary system of a woman works with a double load, as it removes all unnecessary from the body not only of the mother, but also of her child. As a result, the calyces of the kidneys become wider along with the pelvis.

Can the uterus put pressure on the bladder? It usually occurs in the first and third trimesters of pregnancy. And there is an explanation for this:

• In the first weeks, the uterus is located in the pelvic area and there it begins to grow, creating pressure on neighboring organs.
• In the second trimester, the uterus rises higher into the abdominal cavity, and the bladder is slightly released, the pressure is relieved.
• In the third, the uterus enlarges, the grown fetus descends with its head into the pelvic area and pressure is again created on the bladder.

As the fetus grows, the uterus expands and compresses the bladder, forcing urine back to the kidneys. Because of this, it seems to the woman that the bubble is constantly full. In addition, the placenta secretes a hormone that causes spasms of the muscles of the urinary system, which increases pressure on the bladder itself.

Is there any reason for concern?

The uterus is ready for bearing the fetus from the very beginning. It begins to increase from the moment of fertilization. She needs enough space to properly position in the abdominal cavity, and she begins to put pressure on neighboring organs. If there is no inflammation, everything is limited only to frequent urges to the toilet. In the presence of an inflammatory process, a woman feels pain, and she needs to see a doctor to avoid complications.

Causes of pressure

Over time, the uterus is established in its permanent place and partially rises from the small pelvis. In this case, the bladder is slightly released, and the condition of the pregnant woman is normalized. In addition, addiction to the urge develops, and the woman feels good. But if there is pain in the pubic region, then this may be a pathology that needs to be identified:

• The most dangerous may be cystitis caused by pathogenic microbes. During pregnancy, they attack the weakened body of a woman and easily penetrate the genitourinary system, causing inflammation and swelling. The patient suffers from pain when urinating, the urine becomes cloudy.
• Another cause of pelvic pressure may be cystalgia. With it, there is no inflammatory process, and urine remains normal. Otherwise, the symptoms are the same as those of cystitis.
• In the later stages, overfilling of the bladder should be avoided, as this also causes increased pressure on the internal organs.

One way or another, but with any deviations from the norm, a woman should immediately contact her doctor. The presence of cystitis indicates the presence of an infection in the body, which can harm not only the woman's body, but also interfere with the proper development of the fetus.

Symptoms of increased pressure in the pelvis

During pregnancy, a woman has increased pressure in the pelvic area, which may be accompanied by such signs:

• Feeling of fullness in the abdominal region. There is a feeling of bloating.
• The urge to go to the toilet becomes very frequent, but very little urine comes out.
• In some cases, urinary incontinence may occur. This is due to the fact that under the action of progesterone (a hormone secreted by the female body during gestation), the sphincter (the valve that controls urine excretion) relaxes.
• The woman constantly feels discomfort, it seems to her that the bladder is not completely freed.
• Frequent constipation may occur. This is due to the fact that the uterus also presses on the intestines, as a result of which stagnation occurs in it.
• There is periodic pain in the lumbar region. It increases with exertion, with prolonged standing on the legs and with palpation of the abdomen.

These signs may not all be observed at the same time. The presence of at least one of them should alert a woman. Only a doctor can tell where is the pathology and where is the norm.

How to alleviate the condition?

The most dangerous pathology in a pregnant woman can be associated with cystitis. If it is detected, the doctor recommends a reduction in physical activity and the complete exclusion of sexual intercourse. Medications are prescribed, but with caution so as not to harm the developing fetus. For severe infections, antibiotics are prescribed. A special diet is prescribed. A pregnant woman is allowed to go out into the fresh air, but in no case be supercooled.

A pregnant woman should be registered as early as possible and be under the supervision of a gynecologist. She needs to be extremely attentive to her well-being and, in case of any deviations from the norm, immediately consult a doctor. If urination does not cause much concern, there is no pain and the color of the urine does not change, then there is no cause for concern. Frequent urges are provided by nature and are the norm.

- functional disorders of filling and emptying the bladder associated with a violation of the mechanisms of nervous regulation. Neurogenic bladder in children may present with uncontrolled, frequent or infrequent urination, urinary urgency, urinary incontinence or retention, and urinary tract infections. Diagnosis of neurogenic bladder in children is based on laboratory, ultrasound, X-ray, endoscopic, radioisotope and urodynamic studies. Neurogenic bladder in children requires complex treatment, including drug therapy, physiotherapy, exercise therapy, and surgical correction.

General information

Neurogenic bladder in children is a reservoir and evacuation dysfunction of the bladder, caused by a violation of the nervous regulation of urination at the central or peripheral level. The relevance of the problem of neurogenic bladder in pediatrics and pediatric urology is due to the high prevalence of the disease in childhood (about 10%) and the risk of developing secondary changes in the urinary organs.

A mature, fully controlled day and night, urination regimen is formed in a child by the age of 3-4, progressing from an unconditioned spinal reflex to a complex voluntary reflex act. Its regulation involves cortical and subcortical centers of the brain, centers of spinal innervation of the lumbosacral spinal cord, and peripheral nerve plexuses. Violation of innervation in neurogenic bladder in children is accompanied by disorders of its reservoir-evacuation function and can cause the development of vesicoureteral reflux, megaureter, hydronephrosis, cystitis, pyelonephritis, chronic renal failure. Neurogenic bladder significantly reduces the quality of life, creates physical and psychological discomfort and social disadaptation of the child.

Causes of neurogenic bladder in children

The neurogenic bladder in children is based on neurological disorders of various levels, leading to insufficient coordination of the activity of the detrusor and / or the external sphincter of the bladder during the accumulation and excretion of urine.

Neurogenic bladder in children can develop with organic damage to the central nervous system due to congenital malformations (myelodysplasia), trauma, tumor and inflammatory and degenerative diseases of the spine, brain and spinal cord (birth trauma, cerebral palsy, spinal hernia, agenesis and dysgenesis of the sacrum and coccyx, etc. ), leading to partial or complete dissociation of the supraspinal and spinal nerve centers with the bladder.

Neurogenic bladder in children may be due to instability and functional weakness of the formed controlled urination reflex, as well as a violation of its neurohumoral regulation associated with hypothalamic-pituitary insufficiency, delayed maturation of the voiding centers, dysfunction of the autonomic nervous system, changes in the sensitivity of receptors and extensibility of the muscle wall of the bladder . Of primary importance is the nature, level and degree of damage to the nervous system.

Neurogenic bladder is more common in girls, which is associated with higher estrogen saturation, which increases the sensitivity of detrusor receptors.

Classification of neurogenic bladder in children

According to the change in the cystic reflex, hyperreflex bladder (spastic state of the detrusor in the accumulation phase), normoreflex and hyporeflex (detrusor hypotension in the excretion phase) are distinguished. In the case of detrusor hyporeflexia, the urination reflex occurs when the functional volume of the bladder is significantly higher than the age norm, in the case of hyperreflexia, long before the accumulation of normal age-related urine volume. The most severe is the areflex form of the neurogenic bladder in children with the impossibility of independent contraction of a full and overcrowded bladder and involuntary urination.

According to the adaptability of the detrusor to the increasing volume of urine, the neurogenic bladder in children can be adapted and non-adapted (non-inhibited).

Neurogenic bladder dysfunction in children can occur in mild forms (daytime frequent urination syndrome, enuresis, stress urinary incontinence); moderate (lazy bladder syndrome and unstable bladder); severe (Hinman syndrome - detrusor-sphincter dyssenergia, Ochoa syndrome - urofacial syndrome).

Symptoms of neurogenic bladder in children

Neurogenic bladder in children is characterized by various disorders of the act of urination, the severity and frequency of manifestations of which is determined by the level of damage to the nervous system.

With neurogenic overactivity of the bladder, which is predominant in young children, there are frequent (> 8 times / day) urination in small portions, urgent (imperative) urges, urinary incontinence, enuresis.

Postural neurogenic bladder in children manifests itself only when the body moves from a horizontal to a vertical position and is characterized by daytime pollakiuria, undisturbed nocturnal accumulation of urine with a normal volume of its morning portion.

Stress urinary incontinence in puberty girls can occur during exercise in the form of missing small portions of urine. Detrusor-sphincter dyssynergia is characterized by complete urinary retention, micturition during straining, and incomplete emptying of the bladder.

Neurogenic hypotension of the bladder in children is manifested by absent or rare (up to 3 times) urination with a full and overfilled (up to 1500 ml) bladder, sluggish urination with tension in the abdominal wall, a feeling of incomplete emptying due to a large volume (up to 400 ml) residual urine. Possible paradoxical ischuria with uncontrolled release of urine due to the gaping of the external sphincter, stretched under the pressure of an overflowing bladder. With a lazy bladder, infrequent urination is combined with urinary incontinence, constipation, urinary tract infections (UTIs).

Neurogenic hypotension of the bladder in children predisposes to the development of chronic inflammation of the urinary tract, impaired renal blood flow, scarring of the renal parenchyma and the formation of secondary kidney shrinkage, nephrosclerosis and chronic renal failure.

Diagnosis of neurogenic bladder in children

In the presence of urinary disorders in a child, it is necessary to conduct a comprehensive examination with the participation of a pediatrician, a pediatric urologist, a pediatric nephrologist, a pediatric neurologist and a child psychologist.

Diagnosis of neurogenic bladder in children includes taking an anamnesis (family burden, trauma, pathology of the nervous system, etc.), evaluation of the results of laboratory and instrumental methods for examining the urinary and nervous system.

To detect UTIs and functional disorders of the kidneys in neurogenic bladder in children, a general and biochemical analysis of urine and blood, a Zimnitsky, Nechiporenko test, and a bacteriological examination of urine are performed.

Urological examination for neurogenic bladder include ultrasound of the kidneys and bladder of the child (with the determination of residual urine); x-ray examination (micting cystography, survey and excretory urography); CT and MRI of the kidneys; endoscopy (ureteroscopy, cystoscopy), radioisotope scanning of the kidneys (scintigraphy).

To assess the condition of the bladder in a child, the daily rhythm (number, time) and the volume of spontaneous urination are monitored under normal drinking and temperature conditions. A urodynamic study of the functional state of the lower urinary tract has a high diagnostic significance in neurogenic bladder in children: uroflowmetry, measurement of intravesical pressure during natural filling of the bladder, retrograde cystometry, profilometry of the urethra and electromyography.

If a pathology of the central nervous system is suspected, an EEG and) and psychotherapy are indicated.

With detrusor hypertonicity, M-cholinergic blockers are prescribed (atropine, children over 5 years old - oxybutynin), tricyclic antidepressants (imipramine), Ca + antagonists (terodilin, nifedipine), phytopreparations (valerian, motherwort), nootropics (hopantenic acid, picamilon). For the treatment of neurogenic bladder with nocturnal enuresis in children older than 5 years, an analogue of the antidiuretic hormone of the neurohypophysis, desmopressin, is used.

In case of hypotension of the bladder, forced urination according to a schedule (every 2-3 hours), periodic catheterizations, taking cholinomimetics (aceclidine), anticholinesterase agents (distigmine), adaptogens (eleutherococcus, magnolia vine), glycine, therapeutic baths with sea salt are recommended.

In order to prevent UTIs in children with neurogenic hypotension of the bladder, uroseptics are prescribed in small doses: nitrofurans (furazidin), oxyquinolones (nitroxoline), fluoroquinolones (nalidixic acid), immunocorrective therapy (levamisole), herbal teas.

In case of neurogenic bladder in children, intradetrusor and intraurethral injections of botulinum toxin are performed, endoscopic surgical interventions (transurethral resection of the bladder neck, collagen implantation at the mouth of the ureter, operations on the nerve ganglia responsible for urination), an increase in bladder volume using intestinal cystoplasty.

Forecast and prevention of neurogenic bladder in children

With the right therapeutic and behavioral tactics, the prognosis of neurogenic bladder in children is most favorable in case of detrusor overactivity. The presence of residual urine in neurogenic bladder in children increases the risk of developing UTIs and functional disorders of the kidneys, up to CRF.

For the prevention of complications, early detection and timely treatment of neurogenic bladder dysfunction in children is important. Children with neurogenic bladder need dispensary observation and periodic examination of urodynamics.

And urethra is a rare occurrence. They can be detected during pregnancy with an ultrasound. If a defect is detected in the fetus, in most cases the pregnancy is terminated. Some anomalies are treatable and in this case it is important to monitor the size of the organ in question by week of pregnancy.

The bladder in the fetus: the formation and its size by week

The formation of the organ in the fetus begins on the 25-27th day of pregnancy. During this period, the urogenital sinus is formed from the internal germinal lobe. The final formation of the organ occurs when the fetus is at 21–22 weeks of development. The size norm is 8 mm. Anomalies of the urinary system in most cases occur due to diseases of the chromosomal type. The defects that appeared at the time of formation are presented below.

diverticulum

It is characterized by protrusion of the bladder wall. The main symptom is double urination. Pathology occurs due to the inferiority of the muscle layer. For treatment, surgical intervention is used, during which the diverticulum is removed. Congenital diverticula are more often single, less often there are 2 or 3. Emptying of urine from the diverticulum may be complete or incomplete. Small diverticula without symptoms do not require treatment.

Megacystis and hypoplasia

Megacystis is a defect in which the bladder is enlarged. A timely examination will make it possible to make this diagnosis at the initial stages of pregnancy and to detect an enlarged organ in time. With megacystitis, urinary is more than the standard norm. This anomaly may indicate the presence of cropped belly syndrome, which most often has a poor prognosis. To start treatment, diagnosis is used - vesicocentesis. This is an analysis of fetal urine, which is taken during a puncture of the bladder wall. Early vesicocentesis reduces the risk of fetal loss.

Hypoplasia is characterized by congenital reduction of the bladder, often with renal insufficiency. Very often this pathology is confused with agenesis. The capacity of the organ is several milliliters, which from the moment of birth is manifested by urinary incontinence. Depending on the situation, plastic surgery or cystostomy is performed.

Exstrophy, atresia and agenesis

Exstrophy is more common in males than in females. It is characterized by the absence of the anterior abdominal wall of the bladder or its defect. Exstrophy on the echographic picture is manifested by the absence of the bladder on the scan, while the structure of the kidneys remains normal, without changes in the amount of amniotic fluid. Treatment is carried out only by surgery.

Urethral atresia is a rare malformation in which the main indicators are enlargement, distension of the bladder and lack of amniotic fluid. The bladder of the fetus can enlarge so much that it leads to an increase in the abdomen. With this pathology, termination of pregnancy is indicated, with its preservation, in most cases, a dead child is born or severe pulmonary hypoplasia is observed.

Agenesia is an extremely rare anomaly and is characterized by the absence of organ development. The birth rate with this pathology is very low. This disease is usually accompanied by other defects incompatible with intrauterine life. In newborns, the function of urination is preserved, but there is a constant partial retention of urine, and palpation reveals a distended bladder.

Diseases and malformations of the urinary system of the fetus threaten its further normal development and health, so timely prenatal diagnosis, prognosis and appropriate treatment tactics are relevant and important.

Megacystis is called an increase in the fetus during intrauterine development of the bladder in a longitudinal size (more than 8 mm). In addition, the ratio of this parameter to the coccygeal-parietal size increases (more than 10.4%, at the norm - 5.4%). Megacystis is most often found in the early terms of pregnancy (10-15 weeks) in 0.06-0.19% of cases.

The bladder begins to form on the 25-27th day of gestation, with the maturation of the urogenital sinus from the inner lobe of the embryo. The organ is fully formed after 21 weeks of fetal development. Normally, its size is 8 mm.

Anomalies of the urinary system develop most often due to chromosomal type disorders. With ultrasound (ultrasound), it is possible to visualize the urea at 12 weeks of gestation in 80% of cases, and in 100% with ultrasound at 13 weeks.

Causes of pathology

Some researchers argue that if an enlarged bladder is found in a fetus in the first trimester of pregnancy, it will not be possible to determine the true cause of its occurrence. Scientists identify two main etiological causes of the development of megacystis in the fetus:

In the early terms of pregnancy, the diagnosis of an enlarged bladder can only be established by some echographic signs, because during this period there are still no specific indicators that can be used to differentiate intrauterine malformations.

The diagnosis of "megacystis-megaureter-microcolon" is more often diagnosed in female embryos (4:1), and urethral obstruction and Prune-Belly syndrome are diagnosed in males.

In the early terms (11-13 weeks), dilated upper urinary tract does not always indicate megacystis syndrome and is most clearly visualized only after 14 weeks.

What is the prognosis of pathology?

Various studies (5-47 cases) show that an enlarged organ can spontaneously return to its normal size. Megacystis self-regresses, which may result in a favorable perinatal outcome.

Researchers explain this by the fact that the formation of smooth muscles and nerve endings in the bladder continues after the 13th week of embryo development. That does not exclude certain chances for a positive resolution of the problem in the future. You can read about the symptoms and treatment of cystitis in newborns.

However, most researchers predict a negative prognosis for such a pathology, which threatens with various perinatal defects due to dysplasia (especially cystic). The lethal prognosis for the fetus with these disorders ranges from 20-50% of cases due to the occurrence of insufficiency of the respiratory system in the neonatal period or early childhood renal failure.

Taking into account that megacystis syndrome in 25-40% of cases is combined with chromosomal abnormalities, the results of the study of the fetal karyotype and genetic studies will be of primary importance when deciding whether to terminate or prolong pregnancy.