Hydrocolpos in cloacal malformations

Bischoff, Andréa; Levitt, Marc A.; Breech, Lesley; Louden, Emily; Peña, Alberto

doi:10.1016/j.jpedsurg.2010.02.097

Cited by 79 publications

(47 citation statements)

References 13 publications

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“…Anorectal malformations and cloaca can be difficult to detect in the prenatal setting, but hydro(metro)colpos can be the first sonographic feature that leads to a detailed sonographic examination [13, 14]. In fetuses with cloacal malformation, special attention should be paid to the existence of hydro(metro)colpos, as this is present in approximately one-third of newborn patients with cloaca [12]. …”

Section: Discussionmentioning

confidence: 99%

“…In individual cases, hydro(me tro)colpos has been described in fetuses with features of a VACTERL (vertebral, anal, cardiac, trachea-esophageal fistula, renal/kidney, limb defects) or MURCS (Mülleri an agenesis, renal agenesis, cervicothoracic, somite abnormalities) association [8], Herlyn-Werner-Wunder lich syndrome (HWWS), Langer-Giedion syndrome, or Pallister-Hall syndrome [9-11]. Secondary forms of hy dro(metro)colpos occur in fetuses with anorectal malformations [12-14]. …”

Section: Introductionmentioning

confidence: 99%

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Prenatal Diagnosis of Hydro(metro)colpos: A Series of 20 Cases

Mallmann¹,

Reutter²,

Mack-Detlefsen

et al. 2018

Fetal Diagn Ther

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Background: Hydrocolpos and hydrometrocolpos are rare malformations caused by accumulation of secretion due to congenital obstruction of the vagina. Hydro(metro)colpos may be isolated or can be combined with other malformations as part of a syndromic disorder. We report on a series of 20 cases with hydro(metro)colpos diagnosed prenatally, delineate the differential diagnoses, and illustrate the spectrum of associated malformations. Subjects and Methods: This was a retrospective study involving 20 fetuses with hydro(metro)colpos at two large tertiary referral centers in Germany over an 18-year period (2000–2017). Results: The median diagnosis was made at 30⁺⁴ weeks of gestation, the earliest at 20⁺⁶ weeks, the latest at 37⁺² weeks. All 20 fetuses presented with the typical cystic structure behind the fetal bladder. Additional malformations included urogenital malformations, hexadactyly, and heart defects. Postnatal follow-up revealed that hydro(metro)colpos was associated with anorectal malformation in 11/20 fetuses, McKusick-Kaufman syndrome or Bardet-Biedl syndrome in 4/20 fe tuses, Mayer-Rokitansky-Küster-Hauser syndrome in 3/20 fetuses, and Herlyn-Werner-Wunderlich syndrome in 1/20. In 1 fetus pressure from an intraabdominal teratoma resulted in prenatal hydro(metro)colpos. Conclusion: Hydro(me tro)colpos is a rare prenatal sonographic feature. Multidisciplinary prenatal counseling should include all potential syndromes that can present with hydro(metro)colpos in the prenatal setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prenatal Diagnosis of Hydro(metro)colpos: A Series of 20 Cases

Mallmann¹,

Reutter²,

Mack-Detlefsen

et al. 2018

Fetal Diagn Ther

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“…2,3 Variability of perineal outlet obstruction is such that hydrocolpos is only present in 30% to 50% of neonates with cloaca. 13,14 Therefore, at least half of fetal cases will not have a cystic pelvic mass; prenatal diagnosis is much more difficult in these patients, but the combination of renal , which is not always visible on fetal MRI. C, Axial T2-weighted MRI shows the duplicated obstructed vaginas (curved white arrow) and bladder anteriorly (white arrowhead).…”

Section: Discussionmentioning

confidence: 99%

“…Müllerian duplication is present in approximately 60% of pediatric cases and in up to 80% of cases when hydrocolpos is evident prenatally. 14,16 Uterine and vaginal duplication may be partial or complete.…”

Section: A B C Dmentioning

confidence: 99%

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Cloacal Malformation

Winkler¹,

Kennedy²,

Woodward³

2012

Journal of Ultrasound in Medicine

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Embryology, Anatomy, and Prenatal Imaging Featuresloacal malformations constitute a group of severe nonhereditary anorectal malformations. Failure of division of the cloaca or urogenital sinus early in embryogenesis results in either convergence of the genital, urinary, and intestinal contents into a single common channel (cloaca) or the formation of two channels: a common genitourinary channel (urogenital sinus) separate from the hindgut. Although rare, with a quoted incidence of 1 per 20,000 live births, 1 a tertiary referral center may encounter up to 1 or 2 cases per year based on our institutional experience.Recent retrospective reviews by Bischoff et al 2 and Livingston et al 3 found that the prenatal diagnosis of cloacal malformation was suspected in only 6% of their patients with a diagnosis of cloacal malformation at birth, despite the presence of suspicious sonographic findings in as many as 62% of the cases when the prenatal imaging reports were reviewed. 2 The results of their studies indicate a need for improved pattern recognition by obstetric imagers.In this series, we present the prenatal findings in a series of 6 proven cases of cloacal malformation. Characteristic imaging features of our cases in combination with a literature review are described, in addition to pitfalls and important differential considerations. Information on the prognosis and general management is provided for guidance in counseling and referring affected families. Cloacal extrophy is a distinct entity from cloacal malformation and will not be discussed. CASE SERIESCloacal malformation is a rare but important anomaly. Prenatal diagnosis is possible with knowledge of the distinctive imaging features. The purpose of this case series is to illustrate characteristic prenatal sonographic and magnetic resonance imaging features of cloacal malformation using imaging from 6 cases seen at a single academic center to augment published data. The imaging feature common to all cases was a central cystic pelvic mass containing a characteristic fluid-fluid level. Additional anomalies include uterine and vaginal duplication, hydronephrosis, and lumbosacral anomalies. Prenatal magnetic resonance imaging showed the absence of the normal T1-hyperintense meconium-filled rectum in all cases. Prenatal diagnosis may affect immediate neonatal care (eg, immediate drainage of hydrocolpos) with an ultimate improved outcome.

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Fetal hydrometrocolpos: Challenges of prenatal differential diagnosis on ultrasound

Uygur

Demirci

Celayir

2022

J of Clinical Ultrasound

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Hydrometrocolpos is a pelvic cystic mass representing the distension of the vagina and uterus due to a lower genital tract obstruction causing accumulation of utero‐cervical‐vaginal secretions or urine in the vagina and endometrial cavity. Prenatal diagnosis is uncommon and differential diagnosis of the underlying etiologies is quite challenging in the prenatal period. We present three cases of female fetuses with hydrometrocolpos and discuss the prenatal differential diagnoses in the light of ultrasound findings along with postnatal diagnoses and outcomes.

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Hydrocolpos in cloacal malformations

Cited by 79 publications

References 13 publications

Prenatal Diagnosis of Hydro(metro)colpos: A Series of 20 Cases

Prenatal Diagnosis of Hydro(metro)colpos: A Series of 20 Cases

Cloacal Malformation

Fetal hydrometrocolpos: Challenges of prenatal differential diagnosis on ultrasound

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