Antenatal diagnosis of Sirenomelia, the Mermaid syndrome with bilateral renal agenesis

A 26-year-old non-diabetic primigravida with 4 months of amenorrhea was appointed for a routine second-trimester anomaly scan. On inspection, the gravid abdominal girth of the lady did not correlate with her gestational age. Ultrasonographic examination showed a single live intrauterine gestation with anhydramnios. There was an absence of bilateral kidneys and urinary bladder with lying down adrenal sign suggestive of bilateral renal agenesis. The fetus also revealed caudal dysgenesis in the form of fusion of both lower limbs, seen as a single leg with 1 upturned foot and fused toes. There were no identifiable external genitalia and anus. The parents went ahead with medical termination of pregnancy after being informed about the condition and its incompatibility with life.