We describe some fetal ultrasound findings associated with intrauterine 
cytomegalovirus (CMV) infection. We report a 38-year-old gravida 3, para 2 at 16 
weeks of gestation who underwent ultrasound examination for anomaly screening. 
The scan revealed an extensive irregular echogenic area in the fetal brain, 
especially at the level of lateral ventricles, suggestive of intraventricular 
and cerebral hemorrhage. Cardiomegaly, hepatomegaly, and mild ascites as well as 
an echogenic bowel were demonstrated. Abnormal chromosomes and hemoglobin Bart 
disease were excluded by analysis of fetal blood. Follow-up ultrasound at 20 
weeks of gestation showed frank hydrops fetalis, and termination of the 
pregnancy was performed based on the couple's decision, giving stillbirth to a 
male fetus weighing 450 g. Autopsy findings showed intracerebral hemorrhage 
(right cerebral hemisphere) and hydrops fetalis with hepatosplenomegaly. 
Microscopic investigation showed typical changes of CMV infection in several 
organs, including brain, thyroid gland, lung, liver, kidney, heart, pancreas, 
and placenta. Sonographically, the combination of hydrops fetalis, cerebral 
hemorrhage, and hyperechoic bowel should raise the possibility of a CMV 
infection, particularly in cases with no obvious cause of hydrops fetalis.