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Persistent cloaca with fetal ascites: clinical features and perinatal management

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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.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing. This work was supported by Masanori Nishikawa, Chief Director of Department of Radiology.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, 840 Murodo, Osaka, Izumi, 594-1101, Japan

    Taku Yamamichi, Takaaki Sakai, Mina Yoshida, Keita Takayama, Naoko Uga, Satoshi Umeda, Shohei Maekawa & Noriaki Usui

Authors
  1. Taku Yamamichi
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  2. Takaaki Sakai
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  3. Mina Yoshida
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  4. Keita Takayama
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  5. Naoko Uga
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  6. Satoshi Umeda
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  7. Shohei Maekawa
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  8. Noriaki Usui
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Contributions

All authors contributed to the conception and design of the study. Data collection and analysis were performed by all authors. The first draft of the manuscript was written by TY. The draft was reviewed and edited by NU, and all authors commented on the second version of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Taku Yamamichi.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethics approval

Approval for this study was obtained from the institutional review board of Osaka Women’s and Children’s Hospital (protocol no. 1459). The procedures used during this study adhered to the tenets of the Declaration of Helsinki.

Consent to participate

The requirement for signed informed consent was waived because of the retrospective study design and the use of de-identified data. Details of the study were published on an institutional website, and individuals had the right to decline participation.

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Yamamichi, T., Sakai, T., Yoshida, M. et al. Persistent cloaca with fetal ascites: clinical features and perinatal management. Pediatr Surg Int 38, 1577–1583 (2022). https://doi.org/10.1007/s00383-022-05204-0

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  • DOI: https://doi.org/10.1007/s00383-022-05204-0

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