Hi,

Thanks for consulting us.

Actually there could be a list of causes responsible for this appearance on ultrasound.
It could be just a fat & big (Macrosomic) baby presenting with a big abdomen on ultrasound. The cause may vary from just a genetic predisposition (indicated by history of big babies in your family & previous pregnancies), maternal obesity or maternal diabetes.

There can be many congenital abnormalities that may present this way, like; duodenal atresia, pyloric atresia or any other Gastro-intestinal blockage. Fetal Hydrops, Down syndrome, Hirschsprung's Disease, Large kidney & urinary tract obstruction leading to distended bladder & renal pelvis, abdominal wall hernias .e.g. Gastrishisis or Omphalocele may have this sign on ultrasound. Fetal ascites, fetal ovarian cyst or other abdominal cysts may also present this way. Prune belly syndrome, Meconium peritonitis or Hepato splenomegaly are other differentials.

Best for you is to have a tertiary level ultrasound to rule out above causes. God Forbid if something came out wrong you may need a visit to fetal medicine centre for detailed counselling & support.
Also go for a fetal Echocardiography in view of your previous history, if not done already.

If all these tests are OK you should then try to concentrate on your blood sugar levels. If normal glucose tolerance test now, try to repeat it at least every month & if you are overweight try to keep your weight under control or at least try to avoid extra weight gain. A dietitian input may be crucial in this regard.

After delivery show your baby to a Child specialist to make sure all is well.

If you have any other thing in your mind that needs clarification please feel free to write back.

I will be pleased to reply.

Wish you good health & a healthy baby.

Best Regards.

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