PRENATAL ULTRASOUND DIAGNOSIS OF FETAL CANDIDA INFECTION - A COMPLICATION OF A RETAINED INTRAUTERINE CONTRACEPTIVE DEVICE

A 32-year-old woman was referred complaining of abdominal pain and ble eding at 18 weeks' gestation. The striking finding on ultrasound exami nation was of symmetrically enlarged echogenic fetal lungs. In additio n, mediastinal compression, increased echogenicity of the kidneys and bowel, an enlarged liver of decreased echogenicity, and hydrops fetali s, as evidenced by ascites and skin edema, were all present. The diffe rential diagnosis included upper respiratory tract obstruction and cys tic kidney disease. The presence of fetal hydrops together with the ot her findings suggested a poor outcome, and on these grounds therapeuti c abortion was recommended and performed. Subsequent postmortem findin gs explained all the ultrasound abnormalities on the basis of extensiv e fetal candida infection. The presence of a retained intrauterine con traceptive device was considered to be the likely cause and the implic ations of this, together with the ultrasound abnormalities and differe ntial diagnoses, are discussed