Fetal Megacystis – A practical guide

Fetal megacystis is the enlargement of the fetal bladder seen on prenatal ultrasound. Diagnosing the underlying cause of fetal megacystis in the antenatal period is often challenging due to the many possible underlying aetiologies, including various obstructive and non-obstructive causes. This review article is a practical guide to help practitioners distinguish between the various causes, counsel and manage fetal megacystis. It summarizes the evidence on each differential diagnosis and highlights the more recent changes to the definitions of megacystsis in the different trimesters. What’s already known about the topic? - Detection of fetal megacystis leads to an extensive diagnostic conundrum. - Counselling, prognostication, and prenatal management may prove challenging. - Prenatal intervention has been trialled with limited success. What does this review add? - A summary of differential diagnoses of fetal megacystis and how to distinguish between them. - A practical guide to assist with the diagnosis, management and counselling for fetal megacystis in each trimester.