Ultrasonographic findings of VATER association

Abstract

Purpose: VATER association is a combination of congenital anomalies including vertebral defects (V), anal atresia (A), tracheoesophageal fistula (TE), esophageal atresia (E), and radial and renal anomalies (R). This report describes the prenatal progress of four such cases and the features of ultrasonographic findings.Methods: Case (1): the mother was referred at 12 weeks gestation because of a fetal abdominal cyst. Bilateral hydronephroses and an expansive bladder were detected by ultrasonography. At 36 weeks polyhydramnios appeared, and soon she delivered. V, A, TE, E and R were confirmed. Case (2): the mother was referred at 14 weeks because of a fetal abdominal cyst and oligohydramnios. Ultrasonography suggested megalocystis based on urethral atresia. An infant was delivered at 27 weeks and died right thereafter. Autopsy confirmed V, A, R, tracheal atresia, genital anomaly and megalocystis. Case (3): the mother was transported at 37 weeks because of fetal distress. Polyhydamnios had been suspected on a routine office visit. The infant was delivered by cesarean section. TE, E and limb defects were detected. Case (4): the mother was referred at 26 weeks because of anhydramnios and mediastinal shift. Ultrasonography and fetal MRI indicated renal agenesis and congenital diaphragmatic hernia. Autopsy on a stillborn infant revealed V, A, TE, E, R and diaphragmatic hernia.Results and conclusions: The features of ultrasonographic findings of VATER association were abnormality of urinary organs and amniotic fluid volume. However, in the cases with esophageal atresia, estimation of renal function was difficult.