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Enlarged fetal kidneys are characteristic of more than one possible diagnosis. Though infantile polycystic kidney disease is probably the most well known entity and is associated with oligohydramnios, Beckwith-Wiedemann syndrome should be considered in the differential diagnosis especially if a normal or increased amount of amniotic fluid is present. The presence of an omphalocele with a normal karyotype should also arouse suspicion. This constellation of findings carries potential morbidity including macrosomia, fetal hypoglycemia, mental retardation, microcephaly, increased risk of subsequent neoplasia, and even neonatal death. Beckwith-Wiedemann syndrome may not be obvious in the newborn period.

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Sonographers are aware of the controversy surrounding 3D and 4D imaging. The television news features new developments and physician concerns, radio programs discuss the availability of the imaging, and popular magazines feature the controversy of "entertainment ultrasound." In a purely nondiagnostic setting, the imaging is accomplished during the period when the baby has fat and sufficient fluid, and thus it looks recognizably like a baby. This is approximately 24 to 32 weeks, depending on the business. Currently, the offices offering this opportunity include luminary physicians' offices following a diagnostic examination, local physicians who offer the service in their offices, sonographers who open their own offices, and local entrepreneurs who bought equipment from a company that trained them for several days. The questions we ask ourselves are the following:• Should patients be allowed to have this opportunity for nondiagnostic imaging?• Who should be allowed to offer the servicephysicians, sonographers, sonographers employed by businesspeople, or the businessperson alone?

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