Prenatal urinary ascites and persistent cloaca: risk factors for poor drainage of urine or meconium.
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.
Adams
M C
MC
Vanderbilt Children's Hospital, Vanderbilt University, Nashville, Tennessee, USA.
Ludlow
J
J
Brock
J W
JW
Rink
R C
RC
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