Clues and pitfalls in prenatal diagnosis of classic cloacal exstrophy using ultrasonography and magnetic resonance imaging: A case with sequential observation from 17 to 30 weeks' gestation and literature review.

The Journal of Obstetrics and Gynaecology Research
Kanako GondoKimio Ushijima

Abstract

We observed a case of classic cloacal exstrophy (CE) from 17 to 30 weeks' gestation. At 17 weeks, an omphalocele and single umbilical artery (SUA) were diagnosed with a normal female karyotype on amniocentesis. A pelvic cystic adjacent to SUA, considered to be the bladder at 17 weeks, became swollen to form double cysts at 25 weeks. A phallus-like structure along the lower abdomen was additionally detected, leading to the diagnosis of CE. Fetal magnetic resonance imaging (MRI) at 30 weeks confirmed that the phallus-like structure was of intestinal origin. The presence of a non-visualizable bladder together with abdominal wall defect or omphalocele and an elephant trunk-like deformity are key findings in the prenatal diagnosis of classic CE. Fetal MRI was useful in confirming ultrasonographic findings and obtaining additional findings for the diagnosis of CE. We have discussed clues and potential pitfalls in diagnosing CE, with a review of the literature.

References

Sep 11, 1992·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·D S RichardsS M Mahaffey
Dec 1, 1985·American Journal of Obstetrics and Gynecology·I Meizner, J Bar-Ziv
Oct 1, 1987·The Journal of Urology·R S HurwitzF D Stephens
Nov 22, 2008·Fetal Diagnosis and Therapy·D GobbiP Midrio
Jun 7, 2011·Journal of Pediatric Urology·Anju GoyalA P Dickson
Oct 18, 2011·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Marcia L FeldkampJohn C Carey
Nov 28, 2012·Pediatric Radiology·Maria A Calvo-GarciaFoong-Yen Lim
Jan 8, 2014·Urology·Matthew B ClementsVijaya M Vemulakonda
Mar 13, 2016·Seminars in Pediatric Surgery·Jose L PeiroLourenco Sbragia
May 18, 2019·Pediatrics International : Official Journal of the Japan Pediatric Society·Toshinori NakashimaHironori Yamashita

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