Gearhart et al listed ultrasonographic criteria for the diagnosis of classic bladder exstrophy in a fetus. Early diagnosis allows for early surgery and fewer complications. The authors are from Johns Hopkins Hospital.
Features seen on ultrasound:
(1) failure to visualize the bladder in the setting of normal amounts of amniotic fluid and normal appearing kidneys
(2) a lower abdominal bulge
(3) in males a small penis with an anteriorly displaced scrotum
(4) low set insertion of the umbilical cord
(5) abnormal widening of the iliac crests
The diagnosis may be difficult if oligohydramnios is present since the bladder may be hard to visualize.
Exclusion of bladder extrophy: The presence of a full bladder (in exstrophy the urine empties into the amniotic fluid).
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