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Re: Clin case: distended bladderFrom: DJBERCK@aol.comTue Jan 26 12:45:55 1999
At 16 weeks, not all amniotic fluid is from urine. There could still be a serious obstructive uropathy. You may wish to observe the fetus for a prolonged period of time (e.g. 1 hour) to see if the bladder fills or empties. I had a case nearly exactly like this (albeit a male fetus) in which the ascites was not appreciated to be of urinary origin and the ruptured bladder was also not identified for what it was. What does the "group" think? If the amniotic fluid volume is not normal by, say 22 weeks, would anyone put in a vesicoamniotic shunt? This sure sounds like an obstructive uropathy to me . . Sincerely, David J. Berck, MD, MPH, RDMS Albert Einstein College of Medicine New York City
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