Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 1 , Pages 79-83, March 2008

Late Prenatal Diagnosis of Hydrometrocolpos Secondary to a Cloacal Anomaly by Abdominal Ultrasonography with Complementary Magnetic Resonance Imaging

  • Yun-Hsiang Hung

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Ching-Chang Tsai

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Chia-Yu Ou

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Bi-Hua Cheng

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Pao-Chu Yu

      Affiliations

    • Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Te-Yao Hsu

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Te-Yao Hsu, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 83305, Taiwan

Accepted 11 April 2007.

Article Outline

Summary 

Objective

Prenatal diagnosis of a cloacal anomaly is difficult. Magnetic resonance imaging (MRI) can assist in the identification of the connection and continuity of a cystic mass to confirm the diagnosis of a cloacal anomaly.

Case Reports

In the first case, a fetal abdominal cystic mass was observed at 32 weeks of gestation. Ultrasonography revealed a retrovesical septate hypoechoic mass with bilateral hydronephrosis. MRI demonstrated a midline cystic mass connected to a dilated uterus and a possible fistula between the bladder and vagina. In the second case, a fetal abdominal septate cystic mass was identified using ultrasonography at 34 weeks of gestation. MRI was performed and demonstrated hydrocolpos/hydrometrocolpos originating from a uterine didelphis with left dysgenesis and a possible vesicovaginal fistula. After birth, both newborns underwent immediate surgical intervention with good outcomes.

Conclusion

MRI facilitated the prenatal diagnosis of cloacal anomalies and allowed additional time for parental counseling and planning of the delivery method with subsequent neonatal intensive care and surgical and urologic consultations.

Key Words:  cloacal anomaly , hydrometrocolpos , magnetic resonance imaging

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References 

  1. Hayashi S , Sago H , Kashima K , et al.   Prenatal diagnosis of fetal hydrometrocolpos secondary to a cloacal anomaly by magnetic resonance imaging . Ultrasound Obstet Gynecol . 2005;26:577–579
  2. Cilento BG , Benacerraf BR , Mandell J . Prenatal diagnosis of cloacal malformation . Urology . 1994;43:386–388
  3. Zaccara A , Gatti C , Silveri M , et al.   Persistent cloaca: are we ready for a correct prenatal diagnosis? . Urology . 1999;54:367
  4. Ohno Y , Koyama N , Tsuda M , Arii Y . Antenatal ultrasonographic appearance of a cloacal anomaly . Obstet Gynecol . 2000;95:1013–1015
  5. Warne S , Chitty LS , Wilcox DT . Prenatal diagnosis of cloacal anomalies . BJU Int . 2002;89:78–81
  6. Liang X , Ioffe OB , Sun CC . Cloacal dysgenesis sequence: observations in four patients including three fetuses of second trimester gestation . Pediatr Dev Pathol . 1998;1:281–288
  7. Lande IM , Hamilton EF . The antenatal sonographic visualization of cloacal dysgenesis . J Ultrasound Med . 1986;5:275–278
  8. Gaucherand P, Vavasseur-Monot C, Ollagnon E, Boisson C, Labaune JM, Basset T, et al. McKusik-Kaufman syndrome: prenatal diagnosis, genetics and follow up . Prenat Diagn . 2002;22:1048–1050
  9. Chen CP , Liu FF , Jan SW , Chang PY , Lin YN , Lan CC . Ultrasound-guided fluid aspiration and prenatal diagnosis of duplicated hydrometrocolpos with uterus didelphys and septate vagina . Prenat Diagn . 1996;16:572–576
  10. Winderl LM , Silverman RK . Prenatal diagnosis of congenital imperforate hymen . Obstet Gynecol . 1995;85:857–860
  11. Mirk P , Pintus C , Speca S . Ultrasound diagnosis of hydrocolpos: prenatal findings and postnatal follow-up . J Clin Ultrasound . 1994;22:55–58
  12. Odibo AO , Turner GW , Borgida AF , Rodis JF , Campbell WA . Late prenatal ultrasound features of hydrometrocolpos secondary to cloacal anomaly: case reports and review of the literature . Ultrasound Obstet Gynecol . 1997;9:419–421
  13. Winter RM , Baraitser M . London Dysmorphology Database . Oxford: Oxford University Press; 2000;
  14. Geipel A, Berg C, Germer U, Ahrens P, Gloeckner-Hofmann K, Moller J, et al. Diagnostic and therapeutic problems in a case of prenatally detected fetal hydrocolpos . Ultrasound Obstet Gynecol . 2001;18:169–172
  15. Brock WA , Pena A . Cloacal abnormalities and imperforate anus . In:  Kelalis PP ,  King LR ,  Belman AB editor. Clinical Pediatric Urology . 3rd edition. Philadelphia: WB Saunders; 1992;p. 920–942
  16. Pena A , Levitt MA , Hong A , Midulla P . Surgical management of cloacal malformations: a review of 339 patients . J Pediatr Surg . 2004;39:470–479 discussion 470–9.
  17. Jones PG . Exomphalos: a review of 45 cases . Arch Dis Child . 1963;38:180–187

PII: S1028-4559(08)60059-5

doi:10.1016/S1028-4559(08)60059-5

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 1 , Pages 79-83, March 2008

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