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Vaginal delivery after cloacal malformation repair
1Department of Obstetrics and Gynecology, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. jagreenber@bics.bwh.harvard.edu
Background:
Patients with cloacal malformations at birth usually require multiple surgical procedures to correct their anatomic defects. Those who conceive after repairs invariably have had cesarean deliveries on the assumption that vaginal delivery would be difficult and/or dangerous. However, because they usually have undergone multiple previous abdominal procedures, cesarean delivery also may carry greater risks than in the general population.
Case:
A 27-year-old nulligravida was delivered vaginally at 34 1/2 weeks' gestation, with a good maternal and neonatal outcome.
Conclusion:
Judiciously treated, pregnant patients with previously repaired cloacal malformations may be candidates for vaginal delivery.
