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Title of Journal: Pediatr Surg Int

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Abbravation: Pediatric Surgery International

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Springer-Verlag

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10.1007/s10896-011-9391-3

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1437-9813

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Prenatal diagnosis of cloacal malformations

Authors: Andrea Bischoff Marc A Levitt Foong Yen Lim Carolina Guimarães Alberto Peña
Publish Date: 2010/08/20
Volume: 26, Issue: 11, Pages: 1071-1075
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Abstract

Prenatal diagnosis of anorectal malformations currently occurs in 0–159 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 diagnosisA 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 cloacaThe 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 nonvisualization of the bladder 6 twovessel cord 5 dilated bladder 5 intraabdominal calcification 4 polyhydramnios 4 enterolithiasis 4 hydrometrocolpos 3 and dilated ureter 3We 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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