We present 2 cases of congenital megalourethra diagnosed by prenatal ultrasound scan during the second trimester of pregnancy. The first one was associated with features suggesting prune belly syndrome (PBS) in contrast to the other one. Fetal urine biochemistry and fetal serum β2-microglobulin was used to rule out severe renal impairment that would have led to postnatal renal failure soon after birth. In both cases, after extensive counselling, the parents opted against termination of pregnancy and in both cases vaginal delivery of a live neonate occurred. Postnatal follow-up demonstrated that the two infants were found to have mildly altered renal function without any physical or mental development delay. Association with features of PBS didn’t seem to influence the severity of renal function impairment however, but PBS may influence parents’ decision regarding termination because of additional corrective surgery and further infertility.

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