Incidental finding of Posterior Urethral Valve during routine antenatal ultrasound: Diagnostic imaging case report in Botswana

Medical ultrasound is a particularly useful imaging method used in the diagnosis of urinary foetal anomalies. One such foetal anomaly is the posterior urethral valve (PUV), which is a congenital malformation of the male urethra occurring early in gestation life. PUV is a common cause of obstructive uropathy in males and foetal death during pregnancy. We report from a medical imaging perspective on a rare and high-risk case of a PUV detected during routine antenatal ultrasound imaging in Botswana. The first scan performed at 16 weeks of gestation age was unremarkable. However, subsequent antenatal ultrasound scans at and after 20 weeks demonstrated bilateral hydronephrosis, distended ureters, and a urinary bladder which gradually increased with the gestation age. There was also a corresponding reduction in amniotic fluid and foetal movements. As a result of these complications, the pregnancy was classified as a “high-risk.” At 30 weeks, spontaneous labour occurred and a fresh still birth was delivered.