Persistent cloaca with fetal ascites: clinical features and perinatal management
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In brief
In brief
Retrospective study of 17 persistent cloaca patients reveals that prenatal fetal ascites significantly impacts perinatal outcomes, correlating with preterm birth, emergency delivery, lower Apgar scores, and altered neonatal management including need for urinary drainage. Findings suggest fetal MRI should be considered when unexplained ascites is detected prenatally.
Written by the GCMD Library team from the article.
Abstract
Purpose
Fetuses with persistent cloaca are known to develop urine or meconium backflow into the abdominal cavity caused by obstruction of the common channel, thus leading to fetal peritonitis with fetal ascites. We analyzed the impact of prenatal fetal ascites on postnatal clinical features and management.
Methods
This retrospective single-center cohort study was conducted to compare the perinatal parameters of patients with isolated persistent cloaca who were born and treated at our hospital between 1991 and 2021. The clinical features and management of those with and without fetal ascites were compared.
Results
Among the 17 eligible patients, fetal ascites were recognized in seven. The occurrence of fetal ascites was significantly related to preterm birth, higher birth weight z-score, birth via emergency cesarean delivery, low Apgar scores at 1 min and 5 min, higher C-reactive protein levels at birth, longer duration of oxygen administration, the need for a urinary drainage catheter at initial discharge, and shorter neonatal hospital stays.
Conclusions
The postnatal management of patients with persistent cloaca with fetal ascites differed significantly from that of patients without fetal ascites. For patients with unexplained fetal ascites, magnetic resonance imaging may be helpful for determining the definite diagnosis of persistent cloaca.