Prenatal sonographic diagnosis of VATER association

Purpose. We examined the potential role of sonography in the prenatal diagn osis of the VATER association, a spectrum of fetal anomalies that includes vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia. Methods. The sonographic findings in 4 fetuses with prenatal diagnoses of V ATER association were prospectively recorded, along with information on out come and postnatal radiographic findings. Results. VATER association was diagnosed in 4 fetuses at 20, 17, 21, and 29 weeks' menstrual age; All showed bilateral radial atresia and tracheoesoph ageal fistula, visible sonographically as a collapsed or absent stomach wit h polyhydramnios. Two fetuses had vertebral defects. Postnatal radiographic and macroscopic findings confirmed the prenatal diagnosis in all cases. Ot her associated anomalies detected prenatally included single umbilical arte ries (2 cases), ventricular septal defect (1 case), and renal abnormalities (2 cases). Anal atresia, present in 3 of the 4 fetuses, was not detected p renatally. Conclusions. This small series suggests that the VATER association can be r eadily diagnosed in utero. Important clues include radial atresia, absent o r collapsed stomach, and polyhydramnios. Prenatal diagnosis can contribute to clinical decisions regarding pregnancy and neonatal management. (C) 1999 John Wiley & Sons, Inc.