Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

Bilateral hydroureteronephrosis was detected by ultrasound in a male fetus. There was normal amniotic fluid. Bladder wall thickness was not commented on. The diagnosis of probable posterior urethral valves was made. Imaging one week later showed increased hydroureteronephrosis. Amniotic fluid volume was still normal. The mother was treated with steriods to mature the baby's lungs and she was delivered at 32 weeks gestation. The baby did not develop hyaline membrane disease. VCUG on day one of life showed grade IV right and grade V left reflux with a smooth walled bladder and normal urethra (figure 1 and 2).he is being treated with antibiotic and is doing fine.