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Pediatric Surgery International

Erschienen in:

01.11.2010 | Original Article

Prenatal diagnosis of cloacal malformations

verfasst von: Andrea Bischoff, Marc A. Levitt, Foong Yen Lim, Carolina Guimarães, Alberto Peña

Erschienen in: Pediatric Surgery International | Ausgabe 11/2010

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Abstract

Introduction

Prenatal diagnosis of anorectal malformations currently occurs in 0–15.9% of screened cases. In cloacas, these numbers are unknown. We speculate that some images from prenatal ultrasound studies may suggest the diagnosis of cloaca, but are not recognized because of a lack of suspicion for this diagnosis.

Methods

A retrospective review of the medical records of 489 patients born with cloaca was performed; 95 of them had prenatal ultrasound reports that represent the material analyzed for this study. A literature review was performed, finding 31 publications, with 68 cloaca patients detected by prenatal images. The abnormal findings of our patients were compared with those described in the literature to determine the most common abnormal prenatal images found in patients with cloaca.

Results

The 95 ultrasound reports found in our patients described 270 abnormalities, the most frequent were: abdominal/pelvic cystic/mass (39), hydronephrosis (36), oligohydramnios (23), distended bowel/bowel obstruction (19), ascites (15), 2 vessel cord (14), dilated bladder (14), dilated ureter (14), polyhydramnios (10), echogenic bowel (8), multicystic kidney (8), “ambiguous genitalia” (7), hydrops fetalis (7), hydrocolpos (4), absent kidney (3), abnormal spine (3), and anorectal atresia (3). In spite of these findings, the radiologists who interpreted the studies only suspected a cloaca in 6 cases (6%). The literature review showed 212 abnormalities in 68 demonstrated cloaca patients. The most frequent were: abdominal/pelvic cystic/mass (46), hydronephrosis (44), ascites (21), oligohydramnios (20), distended bowel (11), multicystic dysplastic kidney (7), ambiguous genitalia (6), non-visualization of the bladder (6), two-vessel cord (5), dilated bladder (5), intraabdominal calcification (4), polyhydramnios (4), enterolithiasis (4), hydrometrocolpos (3), and dilated ureter (3).

Conclusion

We conclude that it is possible to suspect the diagnosis of cloaca, prenatally, more frequently than what currently occurs, looking at the same images but with an increased index of suspicion for cystic abdominal masses and a combination of gastrointestinal and urological abnormalities.

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Titel: Prenatal diagnosis of cloacal malformations
verfasst von: Andrea Bischoff
Marc A. Levitt
Foong Yen Lim
Carolina Guimarães
Alberto Peña
Publikationsdatum: 01.11.2010
Verlag: Springer-Verlag
Erschienen in: Pediatric Surgery International / Ausgabe 11/2010
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-010-2685-3

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Prenatal diagnosis of cloacal malformations

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Conclusion

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