Isolated Fetal Ascites Secondary to Persistent Urogenital Sinus

Abstract

Objective. To present a case of isolated ascites secondary due to urogenital abnormalities (urogenital sinus) without any other prenatal ultrasound marker. Method. A 36-year-old woman with prenatal isolated ascites delivered a female baby, weighing 2.285 g; ascites was drained at birth and the baby underwent several episodes of urinary retention prior to undergoing X-ray investigations. Results. A voiding cystourethrogram revealed a short urogenital sinus: a vesicostomy was performed. A vaginoscopy revealed double vagina with a large posterior vagina. A posterior sagittal anorectal pull-through with genitoplasty was performed at 2 years old with 1-year follow-up. Conclusions. Though rare, a urogenital abnormality is to be suspected in fetal ascites cases with negative viral tests and no cardiac anomalies. The most common ultrasound marker of such abnormalities (fluid filled cavity) may be missing because of complete drainage of urine through the tubes into peritoneum.

Prenatal Diagnosis of Persistent Urogenital Sinus with Duplicated Hydrometrocolpos and Ascites – A Case Report

“…Persistent urogenital sinus is an extremely rare and variable urogenital malformation [2][3][4][5] secondary to failure of urethrovaginal division at 6 weeks' gestation, resulting in a single-exit chamber for the bladder and vagina to drain through. Usually, there are two perineal orifices, one for urogenital sinus and the other for the anus.…”

“…Very infrequently, ascites could develop as a result of urinary reflux through the Fallopian tubes into the peritoneum [4,5] . Camanni et al [5] described ascites as an isolated ultrasound finding of persistent urogenital sinus.…”

“…Camanni et al [5] described ascites as an isolated ultrasound finding of persistent urogenital sinus. Rarely, ascites may disappear during pregnancy as a result of Fallopian tube obstruction, secondary to a chemical reaction [4] .…”

Fetal ascites and hydrometrocolpos due to persistent urogenital sinus and cloaca: a rare congenital anomaly and review of literature

“…Differential diagnosis of cystic structure in fetal abdomen includes abdominal cyst masses, such as ovarian cyst, mesenteric cyst, urachal cyst, duplicated urinary bladder and other conditions such as mega cystitis-microcolon intestinal hypoperistalsis syndrome, obstructive uropathy and anterior sacral teratoma type IV 4 6. Hydrometrocolpos is also a feature of some genetic syndromes, that is, Bardet-Biedl, McKusick-Kaufman and Pallister-Hall syndromes 7…”

Urinary ascites due to persistent urogenital sinus: A case report and review of literature

“…Persistent UGS commonly presents as hydrometrocolpos but its presentation as fetal ascites is extremely rare [1,2]. We report a preterm infant with antenatal diagnosis of hydrometrocolpos and massive urinary ascites secondary to persistent UGS without any bladder or renal abnormalities.…”