Balikesir, Turkey.

Here are some images showing several associated anomalies in the fetus with trisomy 21 obtained at 19th week of pregnancy.

Images 1, 2: 19 weeks of pregnancy. Fetal profile with normal nasal bone (image 1) and mild pyelectasis (image 2).

Images 3, 4: 19 weeks of pregnancy. Mild pyelectasis (image 3) and hyperechoic bowel (image 4).

Images 5, 6: 19 weeks of pregnancy. Double bubble sign representing duodenal stenosis (image 5) and brachydactyly (image 6).