The numbers of syphilis cases have been increasing considerably, especially in eastern europe, thereby contributing towards
greater chances of cases of congenital syphilis. Some of the complications of congenital syphilis can be detected on two-
dimensional ultrasonography (2DUS), and these are generally manifested in the second trimester of pregnancy. The commonest
ultrasonographic signs are hepatosplenomegaly, placentomegaly, and fetal growth restriction, while lower-frequency occurrences
include intrahepatic calcifications, ascites, fetal hydrops, and even fetal death. Three-dimensional ultrasonography (3DUS) is a
relativelynewimagingtechniquethatisadjuvantto2DUSandenablesdetailedassessmentofthefetalsurfaceanatomy.Wepresent
a case of a 21-year-old primigravida with a diagnosis of congenital syphilis, with obstetric 2DUS findings of hepatosplenomegaly,
ascites, pericardial effusion and hyperechogenicity of the cerebral parenchyma. 3DUS in rendering mode allowed clear assessment
of the fetal limbs, especially the feet, which appeared twisted and lacked some toes. It allowed the parents to understand the
pathologicalconditionbetterandimprovedprenatalmanagementandneonatalfollowup.3DUScanbeusedroutinelyforassessing
fetal malformations resulting from congenital infections.