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    By 15 wk gestation the female labia may be visualized on angled coronal axial view as multiple parallel linear echo patterns.These later become more prominent, and the labia can be readily distinguished from the scrotum by the midline cleft separating the labial folds (9).The Sheba Medical Center Termination of Pregnancy Committee, which is subject to the Israeli civil law, approved all abortions. A.) scanned all the cases, and a multidisciplinary team consisting of an obstetrician, geneticist, pediatric endocrinologist, neonatologist, and pediatric surgeon assessed the results.Prenatal evaluation of the fetuses suspected of having genital maldevelopment or sex discordance consisted of three modalities: A detailed evaluation of the fetal reproductive structures, including the pelvic organs, was performed, in addition to a systemic examination to rule out associated somatic anomalies.An additional US examination is usually performed during the third trimester for evaluation of fetal growth and well-being.

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    At the same time, the widespread use of genetic amniocentesis has resulted in an increased number of mismatches between the chromosome analysis, often performed routinely for reasons not primarily related to gender issues, and the genital anatomy on US (phenotype-genotype discrepancies) (3).The recent identification of many of the genes involved in sex differentiation and the newly developed ability to measure key mediating hormones have made it possible for multidisciplinary teams to conduct a carefully planned prenatal evaluation and provide informed parental counseling.We describe our experience with prenatal diagnosis of sex differentiation disorders in 16 cases.If the uterus appears normal, the most likely diagnosis is a virilized karyotypic female.Prenatal diagnosis allows for early parental counseling and anticipation of medical management postnatally.

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