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Singh A, Mandelia A, Naranje K, Mandal K. Hydrometrocolpos: antenatal diagnosis and postnatal management. BMJ Case Rep 2023; 16:e253985. [PMID: 38129091 DOI: 10.1136/bcr-2022-253985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Hydrometrocolpos is a rare finding in newborns. It can be an isolated finding or may be associated with syndromes. Antenatal diagnosis is possible. It is due to the accumulation of secretion in the uterus, distending it and resulting in abdominal swelling. In case of suspected syndromes, an attempt should be made to look for other organ involvement and genetic diagnosis. We here report a term neonate with hydrometrocolpos, which was antenatally diagnosed and was managed conservatively.
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Affiliation(s)
- Anita Singh
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ankur Mandelia
- Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kirti Naranje
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kausik Mandal
- Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Lee SY, Jackson JE, Hassan AES, Kurzrock EA, McLennan A, Hirose S, Saadai P. Prenatal Rupture of Hydrocolpos in a Cloacal Malformation. Fetal Diagn Ther 2023; 50:158-164. [PMID: 37088075 DOI: 10.1159/000530438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/08/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Cloacal dysgenesis occurs from failure of embryological division of urogenital sinus and hindgut, leading to a single common perineal opening for genitourinary and gastrointestinal tracts. The prenatal diagnosis of cloacal malformation is imprecise, but the clinical correlation of postnatal findings to prenatal history can help reveal explanations for unusual pathological findings in patients with urogenital abnormalities. CASE PRESENTATION A 21-year-old woman was referred after her 20-week ultrasound demonstrated anhydramnios and concern for dilated fetal bowel. Fetal MRI confirmed anhydramnios and a dilated fetal colon, in addition to hydronephrosis and a pelvic cyst. Repeat ultrasound at 27 weeks showed unexpected complete resolution of her anhydramnios but new fetal ascites. The newborn girl was postnatally diagnosed with a cloacal malformation and an unusual near-complete fusion of her labia. She underwent proximal sigmoid colostomy and a tube vaginostomy at birth followed by cloacal reconstruction at 1.5 years old. CONCLUSION In female fetus with a pelvic cyst, one should have a high index of suspicion for cloacal anomaly and consider the possibility of urinary obstruction leading to alteration in amniotic fluid.
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Affiliation(s)
- Su Yeon Lee
- Division of Pediatric General, Thoracic and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA,
| | - Jordan E Jackson
- Department of Surgery, University of San Francisco- East Bay, Oakland, California, USA
| | - Abd-Elrahman Said Hassan
- Division of Pediatric General, Thoracic and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Eric A Kurzrock
- Department of Urologic Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Amelia McLennan
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California, USA
| | - Shinjiro Hirose
- Division of Pediatric General, Thoracic and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Payam Saadai
- Division of Pediatric General, Thoracic and Fetal Surgery, University of California Davis Medical Center, Sacramento, California, USA
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Mérindol N, Lefèbvre C, Hennuy N, Demarche M, Rausin L, Rigo V. [Vulvar mass in neonatal period : spot the difference]. Rev Med Liege 2021; 76:588-591. [PMID: 34357708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We report the cases of two female newborns who present, at the first day, a interlabial mass. In both cases, the antenatal scans were normal, and the clinical examination in the delivery room didn't reveal any other abnormality. Similar features may suggest the same diagnosis. However, in the first case, it is a paraurethral cyst which causes the bulging of vaginal introitus whereas, in the second infant, it is an imperforated hymen. Paraurethral cysts are uncommon and even more so among infants. The diagnosis is primarily clinical, and ultrasound confirms the diagnosis and verifies the absence of other associated anomalies. These cysts usually resolve spontaneously. Rarely, they can lead to urinary retention. The second diagnosis, imperforate hymen, is the most common congenital malformation of the female genital tract. It can lead to hydrocolpos with the upstream accumulation of vaginal secretion and sometimes induce a hydrometrocolpos, with vaginal and uterine dilatation. The resulting mass can cause obstruction of surrounding urinary or digestive structures. Surgical management is generally necessary.
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Affiliation(s)
- N Mérindol
- Service de Pédiatrie, CHC MontLégia, Liège, Belgique
| | - C Lefèbvre
- Service de Néonatologie, CHU Liège et CHR Citadelle, Liège, Belgique
| | - N Hennuy
- Service de Néonatologie, CHU Liège et CHR Citadelle, Liège, Belgique
| | - M Demarche
- Service de Chirurgie pédiatrique, CHR Citadelle, Liège, Belgique
| | - L Rausin
- Service d'Imagerie médicale, CHR Citadelle, Liège, Belgique
| | - V Rigo
- Service de Néonatologie, CHU Liège et CHR Citadelle, Liège, Belgique
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Tanitame K, Tanitame N, Urayama S, Ohtsu K. Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes. Jpn J Radiol 2021; 39:733-740. [PMID: 33840015 PMCID: PMC8338850 DOI: 10.1007/s11604-021-01115-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/30/2021] [Indexed: 12/28/2022]
Abstract
Hemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.
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Affiliation(s)
- Keizo Tanitame
- Department of Diagnostic Radiology, Hiroshima Prefectural Hospital, Minami-ku, Ujinakanda, Hiroshima, 734-8530, Japan.
| | - Nobuko Tanitame
- Department of Radiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Saiko Urayama
- Department of Obstetrics and Gynecology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Kazuhiro Ohtsu
- Department of Maternal and Child Health Research Center, Hiroshima Prefectural Hospital, Hiroshima, Japan
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Garcia Rodriguez R, Pérez González J, Garcia Delgado R, Rodriguez Guedes A, de Luis Alvarado M, Medina Castellano M, Garcia Hernandez JA. Fetal hydrometrocolpos and congenital imperforate hymen: Prenatal and postnatal imaging features. J Clin Ultrasound 2018; 46:549-552. [PMID: 29570797 DOI: 10.1002/jcu.22588] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/21/2018] [Accepted: 02/23/2018] [Indexed: 06/08/2023]
Abstract
Congenital imperforate hymen is probably the most common obstructive anomaly of the female reproductive tract. The accumulation of fluid in the genital tract leads to a distended uterus and vagina, causing hydrometrocolpos. Prenatal diagnosis of fetal hydrometrocolpos is uncommon, with only 22 cases reported in the literature and only a few cases of prenatal imaging of this condition available to date. The main ultrasound finding is a fetal pelvic mass posterior to the bladder and anterior to the rectum. We present the case of a 37-week female fetus with a fetal pelvic mass detected in a routine obstetric ultrasound examination, and the correlation between the prenatal and postnatal findings.
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Affiliation(s)
- Raquel Garcia Rodriguez
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - Julio Pérez González
- Radiodiagnosis Department, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - Raquel Garcia Delgado
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - Azahara Rodriguez Guedes
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - María de Luis Alvarado
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - Margarita Medina Castellano
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - Jose Angel Garcia Hernandez
- Prenatal Diagnosis and Fetal Medicine Unit, Obstetrics and Gynecology Service, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
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Lee S, Carlan SJ, Locksmith G, Perez J. Ascites, hydrocolpos, hydrometrocolpos with normal amniotic fluid in a fetus with partial urorectal septum malformation sequence. J Clin Ultrasound 2013; 41 Suppl 1:28-31. [PMID: 23124600 DOI: 10.1002/jcu.22005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 09/27/2012] [Indexed: 06/01/2023]
Abstract
Urorectal septum malformation sequence (URSMS) describes a range of anatomic anomalies in the urogenital and lower gastrointestinal organs caused by incomplete urorectal membrane septation and persistence of the cloacal membrane. Partial URSMS is a milder version characterized by a single perineal opening. We report a case of partial URSMS that associated an intact Mullerian system, single perineal opening, blind colon, imperforate anus and vagina, urethrovaginal connection, and ambiguous genitalia. Hydrocolpos, hydrometrocolpos, and ascites were seen in utero and confirmed on postnatal surgery. This case describes the changes in sonographic findings that evolved throughout the gestation.
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Affiliation(s)
- Shawn Lee
- Department of Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando Regional Healthcare, Orlando Regional Healthcare, Orlando, FL
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Han BH, Park SB, Lee YJ, Lee KS, Lee YK. Uterus didelphys with blind hemivagina and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome) suspected on the presence of hydrocolpos on prenatal sonography. J Clin Ultrasound 2013; 41:380-382. [PMID: 22678931 DOI: 10.1002/jcu.21950] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 04/09/2012] [Indexed: 06/01/2023]
Abstract
We report the case of a female neonate with ipsilateral renal agenesis and uterus didelphys with blind hemivagina, also known as Herlyn-Werner-Wunderlich (HWW) syndrome. Prenatal sonography revealed the absence of the left kidney and a retrovesical cystic lesion suspected as hydrometrocolpos. Postnatal evaluation confirmed that the cystic lesion was a hydrocolpos associated with double uterus and blind hemivagina (HWW syndrome). HWW syndrome can be suspected prenatally if a retrovesical cystic lesion is detected in a female fetus with unilateral absence of kidney.
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Affiliation(s)
- Byoung Hee Han
- Department of Radiology, Kwandong University College of Medicine Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Jung-gu, Seoul, Korea
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8
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Ayaz UY, Dilli A, Api A. Ultrasonographic diagnosis of congenital hydrometrocolpos in prenatal and newborn period: a case report. Med Ultrason 2011; 13:234-236. [PMID: 21894295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Our purpose is to present the ultrasonographic findings of a rare case of prenatally and postnatally congenital hydrometrocolpos secondary to imperforate hymen. By ultrasonography (US) at 38 weeks of gestation, a retrovesical, 60 x 43 mm pelvic cystic mass, was demonstrated in a female fetus. After delivery, US of the newborn revealed a 77 x 60 mm retrovesical, pear-shaped cystic structure with internal echoes, interpreted as congenital hydrometrocolpos. Mild pelvicaliectasis in the left kidney was associated. At physical examination imperforate hymen was detected and a hymenotomy was done. After the hymenotomy, complete regression of the hydrometrocolpos and of the left renal pelvicaliectasis was demonstrated sonographically.
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Affiliation(s)
- Umit Yasar Ayaz
- Department of Radiology, Ministry of Health, Mersin Women's and Children's Hospital, Mersin, Turkiye.
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Zewdneh D, Shewarega Z. A case of McKusick-Kaufman Syndrome. Ethiop Med J 2011; 49:279-282. [PMID: 21991762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We are reporting a rare case of McKusick- Kaufman Syndrome in a ten-month old female infant from Addis Ababa with difficulty of urination often days duration. Clinical exam revealed supra-pubic mass with tenderness and had left hand postaxial polydactily. Ultrasound and CT scans showed the mass to be hydrometrocolpos posterior to the bladder. Intravenous urography revealed a lower abdomen-pelvic mass displacing and compressing the ureters with bilateral hydronephrosis. Further pelvic exam under anaesthesia revealed hydrometrocolpos with vaginal agenesis. This, to the best knowledge of the authors, is the first ever reported case of the syndrome in Ethiopia.
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Affiliation(s)
- Daniel Zewdneh
- Department of Radiology, School of Medicine, College of Health Sciences, Addis Ababa University
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Dosedla E, Kacerovsky M, Calda P. Prenatal diagnosis of hydrometrocolpos in a Down syndrome fetus. J Clin Ultrasound 2011; 39:169-171. [PMID: 21387330 DOI: 10.1002/jcu.20785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 10/22/2010] [Indexed: 05/30/2023]
Abstract
We report the prenatal sonographic diagnosis of hydrometrocolpos caused by an imperforate hymen in a Down syndrome fetus, with spontaneous evacuation on the third day of life. In this case, sonographic evaluation in the 37th week revealed a large retrovesical, sharply marginated, heterogeneous, unilocular cystic structure within the fetal abdomen extending to the left side of the umbilicus.
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Affiliation(s)
- Erik Dosedla
- III. Department of Gynecology and Obstetrics, Slovak Medical University, 1st Private Hospital Košice-Šaca Inc., Košice-Šaca, Slovak Republic
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Chen CP, Liu YP, Chang TY, Tsai FJ, Chen CY, Wu PC, Chen THT, Wang W. Prenatal diagnosis of persistent cloaca with hydrometrocolpos and ascites by magnetic resonance imaging in one fetus of a dizygotic twin pregnancy. Taiwan J Obstet Gynecol 2010; 49:385-6. [PMID: 21056332 DOI: 10.1016/s1028-4559(10)60082-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2009] [Indexed: 11/16/2022] Open
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12
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Taori K, Krishnan V, Sharbidre KG, Andhare A, Kulkarni BR, Bopche S, Patil V. Prenatal sonographic diagnosis of fetal persistent urogenital sinus with congenital hydrocolpos. Ultrasound Obstet Gynecol 2010; 36:641-643. [PMID: 20549768 DOI: 10.1002/uog.7721] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report a case of persistent urogenital sinus with hydrocolpos and associated renal anomalies diagnosed prenatally at 30 weeks' gestation. The prenatal findings were confirmed on postnatal ultrasonography and genitogram with voiding urethrogram. The imaging features and a review of the literature are discussed. The possibility of hydrometrocolpos secondary to urogenital sinus should be considered on prenatal sonography in the presence of a presacral cystic mass with clear urine or turbid contents and a fluid-debris level (cervical or vaginal secretions). Because the prognosis and neonatal management of isolated hydrocolpos (which usually resolves spontaneously) differ greatly from those of hydrocolpos associated with a cloacal malformation, it is important to diagnose prenatally any associated anomalies in order to allow optimal postnatal management.
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Affiliation(s)
- K Taori
- Department of Radiodiagnosis, Government Medical College, Nagpur, India
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Sonmez G, Aydinoz S, Mutlu H, Ozturk E, Sildiroglu O, Akyol I. Medical image. Hydrocolpos in a child. N Z Med J 2008; 121:115-116. [PMID: 18392068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Guner Sonmez
- Department of Pediatrics, GATA Haydarpasa Teaching Hospital, Uskudar, Istanbul, Turkey
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Abstract
OBJECTIVE The purpose of this study was to describe a series of cases of hydrocolpos that proved to be due to vesicovaginal reflux. METHODS Cases with a diagnosis of hydrocolpos or a fluid-filled vagina identified from our ultrasound database were retrospectively reviewed. The results from sonographic and fluoroscopic studies were reviewed, along with demographic and clinical data. RESULTS Four patients had sonographic findings mimicking obstructive hydrocolpos that resolved after voiding. Fluoroscopic studies showed abnormal urethral morphologic characteristics in all 4, diminished bladder capacity in 3, and vesicovaginal reflux in 3. No anatomic abnormalities were identified. CONCLUSIONS Vesicovaginal reflux can produce vaginal distension that is sonographically identical to obstructive hydrocolpos. This may be due to dysfunctional voiding issues. Postvoid sonography allows proper diagnosis.
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Affiliation(s)
- Emma M Snyder
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr, Columbus, Ohio 43205, USA
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Abstract
We want to stress a diagnostic sign in the diagnosis of pelvic cysts in newborns. In these cases the detection of an attached uterus is proof of a hydrocolpos or in cases with a dilated uterine cavity of a hydrometrocolpos.
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Affiliation(s)
- R Schumacher
- Pediatric X-Ray, Hospital for Sick Children, Mainz.
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Picone O, Laperelle J, Sonigo P, Levaillant JM, Frydman R, Senat MV. Fetal magnetic resonance imaging in the antenatal diagnosis and management of hydrocolpos. Ultrasound Obstet Gynecol 2007; 30:105-9. [PMID: 17588226 DOI: 10.1002/uog.4062] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Hydrocolpos should be considered systematically when an abdominopelvic cystic mass is diagnosed in a female fetus. Because the prognosis and neonatal management of isolated hydrocolpos with spontaneous resolution differs greatly from that of hydrocolpos associated with a cloacal malformation, it is important to ascertain prenatally whether there are associated anomalies. We report the prenatal characteristics of three fetuses with hydrocolpos; in two cases there was spontaneous resolution and one infant was born with digestive tract atresia. The principal ultrasound findings were an oblong anechoic pelvic mass with or without a sagittal septum, located behind a normal bladder. On magnetic resonance imaging (MRI), the cervical imprint on the vagina confirmed the diagnosis of hydrocolpos and helped to diagnose cloacal malformation by demonstrating the absence of meconium beside the bladder on T1 sequences. Our cases show that MRI is useful for differentiating isolated hydrocolpos from hydrocolpos associated with cloacal malformation.
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Affiliation(s)
- O Picone
- Institut national de la santé et de la recherche médicale U782, Université Paris Sud, Hôpital Antoine Béclère, Clarmart, France.
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Dhombres F, Jouannic JM, Brodaty G, Bessiere B, Daffos F, Bénifla JL. Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos. Ultrasound Obstet Gynecol 2007; 30:101-4. [PMID: 17523129 DOI: 10.1002/uog.3998] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Hydrocolpos may be associated with a lower urinary tract obstruction in a spectrum of urorectal malformations ranging from persistent urogenital sinus to cloacal dysgenesis. As cloacal dysgenesis carries the worst postnatal prognosis, detailed prenatal ultrasound should focus on the fetal pelvic anatomy to provide the parents with appropriate prenatal counseling. We report three cases of fetal hydrocolpos associated with low urinary tract obstructions, including two with a normal appearance of the anal canal and rectum on prenatal ultrasound and one with a complex cloacal malformation which contributed to the precise prenatal assignment of the malformation in each case within the spectrum of urogenital sequence malformations.
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Affiliation(s)
- F Dhombres
- Service de Gynécologie-Obstétrique, Hôpital Rothschild, Paris, France
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Shono T, Taguchi T, Suita S, Nakanami N, Nakano H. Prenatal ultrasonographic and magnetic resonance imaging findings of congenital cloacal anomalies associated with meconium peritonitis. J Pediatr Surg 2007; 42:681-4. [PMID: 17448765 DOI: 10.1016/j.jpedsurg.2006.12.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/PURPOSE Cloacal malformations are rare anomalies, occurring in females, and in which they demonstrate a single perineal orifice for urethra, vagina, and rectum. Prenatal ultrasonograms (US) of cloacal malformations sometimes show ascites, hydrocolpos, and hydronephrosis. We herein describe the characteristic prenatal US and magnetic resonance imaging (MRI) findings of the cloacal malformations associated with meconium peritonitis. METHODS The pre- and postnatal records of 11 newborn patients with cloacal malformations, treated in our hospital from 1988 to 2004, were reviewed. All fetuses underwent prenatal US by experienced obstetricians, whereas in addition, fetal MRI was performed in 1 patient. RESULTS The prenatal US and/or MRI findings showed fetal ascites, a multicystic pelvic mass, oligohydramnios, and bilateral hydronephrosis in 5 of 11 patients with cloacal malformations. In these 5 cases, postnatal examinations showed associated hydrocolpos, hydrometrocolpos, and bilateral hydronephrosis; furthermore, 4 of these 5 cases also showed meconium peritonitis at laparotomy. CONCLUSIONS The prenatal US and MRI findings, showing fetal ascites, multicystic pelvic mass, bilateral hydronephrosis, and oligohydraminios are highly suggestive of the cloacal malformations associated with meconium peritonitis.
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Affiliation(s)
- Takeshi Shono
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
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Gilboa Y, Lipitz S, Zalel Y, Achiron R. Prenatal diagnosis of ascites with hydrometrocolpos and uterus didelphys in a monoamniotic twin pregnancy. J Ultrasound Med 2007; 26:373-6. [PMID: 17324989 DOI: 10.7863/jum.2007.26.3.373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Yinon Gilboa
- Ultrasound Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel.
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Soman A, Thayyil S, Ogilvy-Stuart A, Set P, Brain J, Samuel M. Fetal ascites secondary to urinary hydrocolpos. J Perinat Med 2007; 34:347-8. [PMID: 16856830 DOI: 10.1515/jpm.2006.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Subramanian S, Sharma R, Gamanagatti S, Agarwala S, Gupta P, Kumar S. Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus. Pediatr Radiol 2006; 36:1086-9. [PMID: 16810498 DOI: 10.1007/s00247-006-0249-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Revised: 04/05/2006] [Accepted: 05/01/2006] [Indexed: 10/24/2022]
Abstract
Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented.
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Affiliation(s)
- Subramanian Subramanian
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Cianciosi A, Mancini F, Busacchi P, Carletti A, de Aloysio D, Battaglia C. Increased amniotic fluid volume associated with cloacal and renal anomalies. J Ultrasound Med 2006; 25:1085-90. [PMID: 16870904 DOI: 10.7863/jum.2006.25.8.1085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Arianna Cianciosi
- Department of Obstetrics and Gynecology, Alma Mater Studiorum-University of Bologna, 13-40138 Bologna, Italy
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