title: Prenatal urinary ascites and persistent cloaca: risk factors for poor drainage of urine or meconium.
abstract: OBJECTIVE
  The unique confluence of the urinary, genital and gastrointestinal tracts in girls with persistent cloaca potentially results in aberrant drainage of urine and meconium that may be characteristic, allowing a prenatal diagnosis to be made.
  
  
  METHODS
  Three of our last 15 patients with cloacal anomalies presented with urinary ascites due to intraperitoneal reflux through the genital system. In 3 female patients a long, narrow cloaca was associated with a high confluence of the urethra, vagina and rectum. All 3 patients ultimately underwent creation of a cutaneous vesicostomy.
  
  
  RESULTS
  In all 3 cases cutaneous vesicostomy effectively diverted urine away from the cloaca before definitive repair.
  
  
  CONCLUSIONS
  The urethra-like persistent cloaca may result in significant outflow resistance. When combined with high confluence, it may cause aberrant drainage of urine and/or meconium. When such problems are noted prenatally, they are likely to persist postnatally and require intervention.
authors.affiliation: Vanderbilt Children's Hospital, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Adams
authors.forename: J
authors.initials: J
authors.lastname: Ludlow
authors.forename: J W
authors.initials: JW
authors.lastname: Brock
authors.forename: R C
authors.initials: RC
authors.lastname: Rink
mesh_terms: D001201:Ascites / Q000150:complications / Q000175:diagnosis; D002988:Cloaca / Q000002:abnormalities*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008470:Meconium; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D014556:Urine