To investigate the clinical characteristics of fetal megacystis screened by standardized ultrasound in early pregnancy, and to provide a basis for its clinical management.

From January 2018 to January 2022, 43 862 pregnant women were screened by standardized ultrasound in the early pregnancy (11-13⁺⁶ weeks of pregnancy) at the Prenatal Ultrasound Diagnostic Center, the Third Affiliated Hospital of Zhengzhou University. The prenatal data were retrospectively analyzed, and the detected megacystis fetuses and the size of the bladder were recorded, as well as the umbilical artery shown by color Doppler. The pregnancy processes and clinical outcomes were followed, and the etiology was further clarified through postpartum review, pathological examination, and interventional prenatal diagnosis.

A total of 952 cases of fetal dysplasia were detected by ultrasound screening, including 64 cases of megacystis. There were 10 cases with thickening of posterior translucency, 10 with chromosomal abnormalities, 11 with umbilical cyst, 21 with single umbilical artery, 9 with renal echo enhancement, 11 with 'keyhole' sign in early pregnancy, 3 with cardiac abnormalities in early pregnancy, 2 with facial abnormalities, 7 with abnormal abdominal muscle layer, and 8 with limb bone abnormalities. Among 64 cases of megacystis, 43 underwent selective termination of pregnancy, 15 stopped development during follow-up, 2 were born without abnormalities, 4 male fetuses underwent surgery for lower urinary tract obstruction after birth, and autopsy confirmed that there were 5 cases of dried plum abdomen syndrome.

Ultrasound screening in early pregnancy can effectively detect and diagnose fetal megacystis, provide appropriate clinical consultation for its possible causes and clinical outcomes, and help with early obstetric and clinical management.