Managing Fetal Trunk Anomalies

The fetal chest and abdomen present a wide range of anomalies that, when initially identified, can be challenging to categorize and assess for potential sequelae within the fetus. The fetal trunk, in particular, is complex, as most of the organs in this area significantly affect the fetus's well-being while in utero. Proper categorization of these anomalies is crucial for scheduling follow-up ultrasounds during the second and third trimesters and for providing vital information to the obstetric team, which aids in delivery management and determining whether immediate intervention is necessary during or after birth.

This presentation will focus on chest anomalies such as CPAM and congenital diaphragmatic hernia, which often exert pressure on the fetal bronchopulmonary system, leading to excess amniotic and hydropic fluid. The bronchopulmonary tree, including the bronchi, trachea, and esophagus, will be reviewed, particularly in cases where a fetus presents with polyhydramnios but without a visible chest lesion.

We will also explore the assessment of abdominal organs that are less commonly examined, including the fetal liver, spleen, and gallbladder. These organs become more critical for evaluation when the mother has tested positive for various infections or autosomal disorders. Additionally, venous anomalies and their connections to abdominal issues, such as PRUV and absent ductus venosus, will be discussed. Lastly, the urinary system will be covered, with a focus on the assessment of pylectasis.