This was a retrospective analysis of ultrasonographic and echocardiographic examinations in 12 fetuses with postnatally confirmed Cloacal Malformation. All examinations were conducted at the tertiary fetal diagnostic center (none of the preliminary screening diagnoses were correct). The main manifestations of cloacal malformation were: signs of urinary tract malformations in 10 fetuses (83,33%), pelvic cyst, diagnosed or suspected as hydrocolpos in 9 fetuses (75%), signs of lower part of digestive tract obstruction in 6 fetuses (50%). In addition there were abnormalities in echocardiographic examinations in 6 cases, such as symptoms of cardiac failure (cardiomegaly, tricuspid regurgitation, monophasic inflow, pericardial effusion, ascites) and one case with AS ( aortal stenosis). Functional abnormalities in fetal echocardiography suggest increased preload or afterload and early circulation failure in this severe prenatal malformation. This malformation have never been published before. The data suggest, that fetal functional echocardiography abnormalities in cases of abnormal pelvic structures should alert the clican to possibility of the presence of cloaca.
1. Bianchi D. W., D’Alton M. E. Persistent Cloaca, Fetology, Diagnosis and Management of the Fetal Patient, second edition, s. 585-589, ISBN 978-0-07-144201-5, McGraw-Hill Medical, New York 201
2. Bischoff A, Levitt MA, Lim FY, Guimaraes C, Pena A. Prenatal diagnosis of cloacal malformations. Pediatr Surg Int. 2010 Nov;26(11):1071-5. doi: 10.1007/s00383-010-2685-3.
3. Levitt MA, Pena A. Cloacal malformations: lessons learned from 490 cases. Semin Pediatr Surg. 2010 May;19(2):128-38. doi: 10.1053/j. sempedsurg.2009.11.012..
4. Bischoff A, Calvo-Garcia M. A., Baregamian N., Prenatal counseling for cloaca and cloacal exstrophy-challenges faced by pediatric surgeons Pediatr Surg Int. 2012 August; 28(8): 781-788. Published online 2012 August 10. doi: 10.1007/s00383-012-3133-3
5. Holschneider A. M., Scharbatke H. Persistent Cloaca - Clinical Aspects, Anorectal Malformations in Children, Embryology, Diagnosis, Surgical Treatment, Follow-up ISBN-10 3-540-31750-3 Springer Berlin Heidelberg New York 2006
6. Słodki Maciej, Respondek-Liberska Maria, Piaseczna-Piotrowska Anna. [Prenatal diagnosis of developmental disorders of lower urinary tract, vagina and rectum in the fetus]. Prenat Cardio. 2011 Dec;1(2):18-21. [Polish]
7. Baka-Ostrowska M. Comments to: Słodki Maciej, Respondek- Liberska Maria, Piaseczna-Piotrowska Anna. [Prenatal diagnosis of developmental disorders of lower urinary tract, vagina and rectum in the fetus]. Prenat Cardio. 2011 Dec;1(2):18-21. [Polish]
8. Mori M, Matsubara K, Abe E Prenatal diagnosis of persistent cloaca associated with VATER (vertebral defects, anal atresia, tracheo-esophageal fistula, and renal dysplasia). Tohoku J Exp Med. 2007 Dec;213(4):291-5.
9. Respondek-Liberska M., Krason M., Karczmarek P Fetal hydrometrocolpos: not only diagnostic but also therapeutic dilemmas Ultrasound in Obstetrics & Gynecology 1998, 11, 2, 155-156