title: Cloaca in discordant monoamniotic twins: prenatal diagnosis and consequence for fetal lung development.
abstract: Objective Describe a case of cloaca prenatally diagnosed in one of a set of monoamniotic twins. Study Design Retrospective review of a case. Results Cloaca is one of the most complex and severe degrees of anorectal malformations in girls. We present a discordant cloaca in monoamniotic twins. Fetal ultrasound showed a female fetus with a pelvic midline cystic mass, a phallus-like structure, a probable anorectal atresia with absence of anal dimple and a flat perineum, and renal anomalies. The diagnosis was confirmed by fetal magnetic resonance imaging postnatally. Conclusions The rarity of the malformation in a monoamniotic pregnancy, the difficulties of prenatal diagnosis, the pathogenic assumptions, and the consequences of adequate amniotic fluid for fetal lung development are discussed.
authors.affiliation: Department of Obstetrics and Gynecology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Yvon
authors.initials: Y
authors.lastname: Chitrit
authors.affiliation: Department of Obstetrics and Gynecology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Edith
authors.initials: E
authors.lastname: Vuillard
authors.affiliation: Department of Developmental Biology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Sunavy
authors.initials: S
authors.lastname: Khung
authors.affiliation: Department of Pediatric Imaging, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Belarbi
authors.affiliation: Department of Developmental Biology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Guimiot
authors.affiliation: Laboratory of Biochemistry and Hormonology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Francoise
authors.initials: F
authors.lastname: Muller
authors.affiliation: Department of Pediatric Urology and Surgery, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Alaa El
authors.initials: AE
authors.lastname: Ghoneimi
authors.affiliation: Department of Obstetrics and Gynecology, Robert Debré Hospital-AP-HP, Paris, France.
authors.forename: Jean Francois
authors.initials: JF
authors.lastname: Oury
keywords: discordant; fetal lung development; monoamniotic twins; persistent cloaca; prenatal diagnosis