Prenatal diagnosis of fetal hydrometrocolpos secondary to a cloacal anomaly by magnetic resonance imaging.
Fetal female urogenital anomalies are often difficult to evaluate by ultrasonography, especially in late gestation. We report a case of fetal hydrometrocolpos detected at 35 weeks of gestation. Ultrasonography revealed a large retrovesical septate hypoechogenic mass in the fetal abdomen, however the sonographic findings were inconclusive. Magnetic resonance imaging (MRI) confirmed that the abdominal mass was fluid-filled with a mid-plane septum in the midline posterior to the bladder, and showed a connection to the dilated uterus that was duplicated. These findings were consistent with a diagnosis of hydrometrocolpos with septate vagina and uterus didelphys. The neonate showed abdominal distension, ambiguous genitalia and anal atresia with a single perineal opening. Hydrometrocolpos was secondary to a urethral type of cloacal anomaly. Aspiration of the mass and a colostomy were performed on the first postnatal day, followed by anorectoplasty at 19 months of age. MRI is a useful complementary tool for assessing fetal urogenital anomalies when ultrasonography is inconclusive.
Hayashi
S
S
Division of Fetal Medicine, National Center for Child Health and Development, Tokyo, Japan.
Sago
H
H
Kashima
K
K
Kitano
Y
Y
Kuroda
T
T
Honna
T
T
Nosaka
S
S
Nakamura
T
T
Ito
Y
Y
Kitagawa
M
M
Natori
M
M
D000328:Adult; D002988:Cloaca / Q000002:abnormalities* / Q000601:surgery; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D052202:Hydrocolpos / Q000175:diagnosis* / Q000601:surgery; D006869:Hydronephrosis / Q000175:diagnosis / Q000601:surgery; D007089:Image Enhancement; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis / Q000379:methods*; D012007:Rectum / Q000002:abnormalities / Q000196:embryology; D014599:Uterus / Q000002:abnormalities / Q000196:embryology; D014621:Vagina / Q000002:abnormalities / Q000196:embryology