Hydrocolpos, uterus didelphys and septate vagina in association with ascites: antenatal sonographic detection.

Manzella, Adonis; Filho, Paulo Borba

doi:10.7863/jum.1998.17.7.465

Cited by 15 publications

(19 citation statements)

References 10 publications

(21 reference statements)

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“…It may appear as a purely anechogenic structure or present fluid–debris levels corresponding to mucosa and cell debris4. When associated with Müllerian duct anomalies or their derivatives, it may appear as a septate mass4, 5.…”

Section: Discussionmentioning

confidence: 99%

Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos

Dhombres

Jouannic

Brodaty

et al. 2007

Ultrasound in Obstet & Gyne

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Hydrocolpos may be associated with a lower urinary tract obstruction in a spectrum CASE REPORTS Case 1A 31-year-old gravida 4, para 3, was referred to our unit at 33 weeks' gestation for ultrasound evaluation of a fetal pelvic cystic mass. Previous ultrasound examination at 22 weeks' gestation had demonstrated normal fetal development. Detailed ultrasound examination revealed a female fetus with biometry consistent with gestational age, with a median pelvic cyst measuring 38 × 48 × 68 mm, with a 10-mm cystic structure at its lower part. Mild bilateral hydronephrosis was noted, with a mild dilatation of the proximal right ureter. Amniotic fluid volume was normal. The bladder was of normal appearance. The fetal uterus was not clearly visible. The sacrum was normal. The anal canal with its mucosa was visible (Figure 1) and dilatation of neither the rectum nor the lower intestinal tract were noted. The working diagnosis was hydrocolpos but the parents were informed that this condition might be associated with a more complex urogenital malformation (i.e. urogenital sinus and cloacal dysgenesis). Both amniocentesis and magnetic resonance imaging (MRI) examinations were declined by the parents. At 35 weeks' gestation the pelvic cystic mass measured 79 × 71 × 57 mm and both ureters were dilated at their proximal part. The child was vaginally delivered at 38 weeks' gestation. The perineum was normal with an intact, normally-positioned, perforate anus. No urethral orifice could be identified. Instead, one orifice corresponding to a persistent urogenital sinus was shown by endoscopic examination. Both the bladder and the hydrocolpos were drained for 24 h and normal spontaneous micturition was obtained. The neonate was discharged at 1 week and anatomical surgical correction was planned for 6 months later. Case 2A 31-year-old primigravida with a dichorionic twin pregnancy was referred for the evaluation of an enlarged bladder found in one fetus at nuchal translucency scan at 12 weeks' gestation. The nuchal translucency measurements were within the normal range. An anomaly scan performed at 14 weeks' gestation showed two dichorionic, diamniotic twins, with an enlarged 19 × 17-mm bladder in one fetus but with normal filling and emptying. A hypoechogenic structure was seen attached to the perineum. At 18 weeks' gestation, this structure was thought to be a penis with a dilatation of the ureter; however, no scrotum was observed. Amniocentesis revealed normal karyotype (46,XX) for both fetuses. No SRY gene expression was found in the amniotic fluidCorrespondence to: Dr J

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Section: Discussionmentioning

confidence: 99%

Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos

Dhombres

Jouannic

Brodaty

et al. 2007

Ultrasound in Obstet & Gyne

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“…Moreover, 30% of these patients suffer from hydrocolpos a condition that must be suspected, diagnosed and treated during the newborn period as it can aggravate an already existing urological condition by compressing the trigone of the bladder causing megaureters and hydronephrosis 16 . Upon observation of uterine and vaginal duplication, Manzella et al, speculated that cloaca malformations or urogenital sinus interfered with müllerian duct fusion 17 . When a series of 22 patients born with cloaca reached puberty, a concern arose as it was found that 60% these patients were found to have duplicated Müllerian systems that might become obstructed and manifest as an acute abdomen during menarche 18 .…”

Section: Cloaca Malformation: the Most Complex And Severe Form Of Anomentioning

confidence: 99%

The great divide: septation and malformation of the cloaca, and its implications for surgeons

et al. 2014

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The anorectal and urogenital systems arise from a common embryonic structure termed cloaca. Subsequent development leads to the division/septation of the cloaca into the urethra, urinary bladder, vagina, anal canal, and rectum. Defective cloacal development and the resulting anorectal and urogenital malformations are some of the most severe congenital anomalies encountered in children. In the most severe form in females, the rectum, vagina, and urethra fail to develop separately and drain via a single common channel known as a cloaca into the perineum. In this review, we summarize our current knowledge of embryonic cloaca development and malformation, and compare them to what has already been described in literature. We describe the use of mouse models of cloaca malformation to understand which signaling pathways and cellular mechanisms are involved in the process of normal cloaca development. We also discuss the embryological correlation of the epithelial and stromal histology found in step sections of the common channel in fourteen human cloaca malformations. Finally, we highlight the significance of these findings, compare them to prior studies, and discuss their implications for the pediatric surgeons. Understanding and identifying the molecular basis for cloaca malformation could provide foundation for tissue engineering efforts that in the future would reflect better surgical reconstruction and improved quality of life for patients.

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“…The second type is associated with a persistent urogenital sinus and cloacal anomaly. 3,5 Fetal ascites can be detected at an early stage of cloacal anomalies. The urine escapes through the fallopian tubes into the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

“…1 Other anomalies associated with persistent cloaca are imperforate anus, urinary anomalies (persistent urogenital sinus, renal agenesis, polycystic kidneys, urethrovaginal or urethrouterine fistula), bicornuate uterus, septate vagina, polydactyly, abdominal wall defect, congenital hip dislocation, esophageal atresia, and sacral hypoplasia. 3,4,6,7 Despite these ultrasound findings the prenatal diagnosis of cloacal abnormalities remains challenging. An accurate diagnosis requires correlation of prenatal and postnatal observation.…”

Section: Discussionmentioning

confidence: 99%

Persistent Cloaca

Baier¹,

Tank²,

Watson

2001

Journal of Diagnostic Medical Sonography

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Hydrometrocolpos is a rare congenital disorder in which excessive mucus secretions accumulate from a genital tract obstruction resulting in cystic dilatation of the vagina and uterus. The spectrum of hydrometrocolpos is broad, ranging from mild cases undetected until adolescence to more severe conditions described prenatally as a large pelviabdominal cystic mass. The authors describe the prenatal sonographic detection of a double cystic pelvic mass subsequently proven to be hydrometrocolpos in a fetus with marked ascites, pyelocaliectasis, pulmonary hypoplasia, and uterine duplication.

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Hydrocolpos, uterus didelphys and septate vagina in association with ascites: antenatal sonographic detection.

Cited by 15 publications

References 10 publications

Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos

Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos

The great divide: septation and malformation of the cloaca, and its implications for surgeons

Persistent Cloaca

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