Late prenatal diagnosis of hydrometrocolpos secondary to a cloacal anomaly by abdominal ultrasonography with complementary magnetic resonance imaging.
OBJECTIVE
Prenatal diagnosis of a cloacal anomaly is difficult. Magnetic resonance imaging (MRI) can assist in the identification of the connection and continuity of a cystic mass to confirm the diagnosis of a cloacal anomaly.


METHODS
In the first case, a fetal abdominal cystic mass was observed at 32 weeks of gestation. Ultrasonography revealed a retrovesical septate hypoechoic mass with bilateral hydronephrosis. MRI demonstrated a midline cystic mass connected to a dilated uterus and a possible fistula between the bladder and vagina. In the second case, a fetal abdominal septate cystic mass was identified using ultrasonography at 34 weeks of gestation. MRI was performed and demonstrated hydrocolpos/hydrometrocolpos originating from a uterine didelphis with left dysgenesis and a possible vesicovaginal fistula. After birth, both newborns underwent immediate surgical intervention with good outcomes.


CONCLUSIONS
MRI facilitated the prenatal diagnosis of cloacal anomalies and allowed additional time for parental counseling and planning of the delivery method with subsequent neonatal intensive care and surgical and urologic consultations.
Hung
Yun-Hsiang
YH
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung, Taiwan.
Tsai
Ching-Chang
CC
Ou
Chia-Yu
CY
Cheng
Bi-Hua
BH
Yu
Pao-Chu
PC
Hsu
Te-Yao
TY
D000328:Adult; D001006:Anus, Imperforate / Q000000981:diagnostic imaging* / Q000473:pathology; D003560:Cysts / Q000000981:diagnostic imaging; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D052202:Hydrocolpos / Q000000981:diagnostic imaging* / Q000473:pathology; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000473:pathology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014624:Vaginal Fistula / Q000000981:diagnostic imaging* / Q000473:pathology