In this manuscript we report 3 cases of severe lower urinary tract obstruction diagnosed before 20 weeks of pregnancy. All cases had a very similar prenatal presentation with a megacystis, bilateral hydro-ureteronephrosis and increased echogenicity of the kidneys. High-resolution postmortem magnetic resonance imaging (MRI), following termination of pregnancy, enabled accurate investigation of the underlying cause of the urinary tract obstruction, by depicting the presence of an urethral valve, urethral atresia and cloacal dysgenesis. Postmortem fetal MRI provides high anatomical detail and is very suitable to investigate congenital anomalies of the lower urinary tract. In case (timely or consented) conventional autopsy is not possible, MRI is an excellent alternative.

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