Hydronephrosis Quiz: Ace Your Exams

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A 30-year-old primigravida woman at 24 weeks of gestation comes to the office for a routine prenatal evaluation. The pregnancy has been uncomplicated, and she has been compliant with prenatal care. She takes vitamins as needed. Family and medical history are unremarkable. She did not have prior abortions or miscarriages. During ultrasound examination of the fetus, male external genitalia are visible, as well as bilateral hydronephrosis. An amniotic fluid index is equivocal. Which of the following is most likely the cause for the abnormal findings?  

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