Pakistan

This is a primigravida at 34 weeks gestation and came for her first ultrasound. There is a multi-loculated cystic mass in fetal abdomen. Both kidneys and urinary bladder are normal. The amniotic fluid is adequate and there is no other apparent gross anomaly in other organs. It is a female fetus with a very good biophysical profile.

At 35 weeks she presented with strong uterine contractions. The biophysical profile was OK, and the baby was delivered with good APGAR and weight of 1800gm.
 
The baby passed urine but was unable to pass meconium for 48 hours, however the abdomen remained soft. Oral feeding was attempted but there was problem of milk regurgitation. So intravenous fluids and prophylactic antibiotics started. Also the baby developed little jaundice for which phototherapy also started.
 
An erect X-ray was performed and subsequently the baby was seen by pediatric surgeon who quickly diagnosed that baby had jejunal atresia. At the age of 3 days, baby underwent surgery and diagnosis was confirmed. The surgery was successful and the baby is doing fine and passed the meconium.