Prenatal Diagnosis and Postnatal Ultrasound Findings of Cloacal Anomaly: A Case Report

Abstract

Cloacal malformation is an extremely rare fetal pathological condition that presents as a variety of defects. It predominantly affects females, with prevalence of 1 in 50,000 births. Prenatal ultrasonography on a 20-year-old caucasian woman (G4P1A2) at 33 weeks of pregnancy showed the fetus having a large cystic mass in the lower abdomen with a single septum, bilateral hydronephrosis, ambiguous genitalia, and a single umbilical artery. The pregnancy developed accentuated oligohydramnios, and presence of a fetal brain-sparing effect was diagnosed using arterial Doppler velocimetry. The newborn showed abdominal distension, ambiguous genitalia, and rectal atresia, with a single perineal opening. Pelvic ultrasound done on the first day after delivery revealed the presence of a large retrovesical septated cystic mass of dense content in the fetal abdomen, and bilateral hydronephrosis. Hysterotomy was performed, and 70 mL of dense liquid was drained through an abdominal colostomy. The infant died on the 27th day of life as a result of infectious complications. Prenatal diagnosing of female urogenital anomalies is usually difficult because of their rarity, different types of manifestation, and lack of characteristic ultrasound signs. Presence of a septated cyst with dense content in the fetal abdomen confirms the finding of hydrometrocolpos, thus raising clinical suspicion of a cloacal anomaly.

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

“…The index case underwent vaginostomy to prevent hydronephrosis and distension of the bladder. Absence of bladder and renal anomalies is a distinct feature in our patient, similar to the case reported by Camanni et al [2], whereas all other case reports, to our knowledge had bladder and renal abnormalities as a predominant feature [3,4,[10][11][12]. We do not have clear explanation for the polyhydramnios seen only in the earlier antenatal scans.…”

AIRP Best Cases in Radiologic-Pathologic Correlation: Prenatal and Postmortem Imaging of a Complex Cloacal Malformation

“…Nevertheless, these US findings were inconclusive. At targeted prenatal US performed at 28 weeks of gestation at our institution, the two cystic masses were correctly interpreted as two hemivaginas with uterus didelphys, findings similar to those noted in previous reports (14,15). Prenatal imaging in (7).…”

Neonatal and infantile fistulas: spectrum of findings on conventional contrast imaging with surgical correlation

“…Thomeer et al [25] examine neonates with ano-rectal malformations, and they found 9 cases with recto-bulbar urethral fistula, 6 cases with recto-prostatic urethral fistula, one case with bladder neck fistula, and one neonate with recto-perineal. Cloacal cystic anomalies were associated with anorectal malformations in our study in 2 cases [26,27]. Vesico-ureteric reflux was found in 3 cases.…”

“…Vesico-ureteric reflux was found in 3 cases. Cloacal anomalies and vesico-ureteric reflux are frequently associated with ano-rectal malformations [26][27][28]. Acquired perineal fistula was reported in 4 cases in this study.…”