A 35-year-old woman presented at 23 weeks’ gestation for a routine transabdominal ultrasound to exclude any congenital fetal anomalies. This was her first pregnancy, and she had not undergone any previous ultrasound scans. To date, her pregnancy has been uneventful. Prior to this pregnancy, the woman’s menstrual cycles had been normal, and she has had no history of any major illnesses. The patient has had amenorrhea since becoming pregnant and has had no vaginal discharge or bleeding during the pregnancy.

Clinical examination: All vital signs were within normal limits, including blood pressure, which was 124/82 mm Hg. Her chest examination was normal as well. The abdominal examination revealed a fundal height that corresponded to a gestational age of 25 weeks, which exceeded the expected fundal height for a 23-week pregnancy. Imaging studies: The ultrasound images from this routine exam…