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In this report, we present a case of twin-twin transfusion syndrome in the presence of the thick dividing wall of each sac in dichorionic twins. The dichorionic diagnosis was based on the presence of the lambda sign at the first-trimester ultrasound evaluation. In addition to fetoscopic and pathological investigation, DNA typing confirmed that the twin set was monochorionic and monozygotic. This case illustrates that although extremely uncommon, the presence of lambda sign does not exclude monochorionic pregnancy.

Background: Fetal urinary ascites is a condition that is rarely encountered. A review of previous reports suggests that the clinical course of the affected fetuses is highly variable. Methods: In this report, we describe a case in which urinary ascites was observed after vesicocentesis in a fetus with megacystis caused by posterior urethral valve. Results: The urinary ascites was transient, and the fetal outcome was good after a successful vesicoamniotic shunting operation. Conclusions: In utero bladder rupture or injury and the subsequent appearance of urinary ascites may be well tolerated by the fetus. Further, spontaneous resolution can be expected during fetal life; therefore, it appears to be preferable to opt for conservative management in fetuses with urinary ascites. Urinary ascites, particularly after vesicocentesis, should be observed with extreme caution.

Prenatal sonographic findings of lymphangiomas characteristically appear as thin-walled, multiseptate hypoechogenic masses. In our case, a retroperitoneal hypoechogenic mass was detected at 26 weeks of gestation by sonography. Serial sonographic examinations demonstrated multiple septations at 29 weeks of gestation, which in retrospect was a classical finding of retroperitoneal lymphangioma. MRI at 38 weeks of gestation revealed a multilocular mass, which was homogeneous, low on T1-weighted and high on T2-weighted images, in the left retroperitoneal cavity. These findings were compatible with the diagnosis of a lymphangioma. This case shows the change in characteristic imaging features, from a unilocular to multilocular pattern, of a lymphangioma with regard to gestational age. It is important to observe the size and extension of such tumors in order to determine the prospect for neonatal prognosis, as well as to make decisions on the delivery timing and style.

Congenital megalourethra is a rare urogenital malformation that is usually associated with lower urinary tract obstruction. In association with hypoplasia or deficiency of the corpus spongiosa and/or corpus cavernosum, a cystic dilatation of penile urethra is generally observed. We present a case of congenital megalourethra diagnosed by fetoscopy and ultrasonography at 17 weeks of gestation. Fetoscopic investigation demonstrated a balloon dilatation of the penis with a complete obstruction of the urethral meatus, which could distinguish a fusiform type congenital megalourethra from other disorders. Autopsy subsequent to the termination of pregnancy revealed a complete deficit of both corpus spongiosa and corpus cavernosum.

An abdominal aortic aneurysm is a rare disease in the paediatric population and is mainly caused by intrauterine infection, connective tissue diseases, such as Ehlers-Danlos syndrome and Marfan’s syndrome, and iatrogenic trauma due to umbilical artery catheterization. Although several cases have been reported in the English literature, they were rarely diagnosed prenatally. Vascular obstruction in utero is also believed to be the major cause of porencephaly. Recently, gene mutations have been reported as the cause of both the above-mentioned diseases. We present a prenatally diagnosed case of congenital abdominal aortic aneurysm with porencephaly.