Persistent cloaca with fetal ascites: clinical features and perinatal management

Area of Science:

• Pediatric Surgery
• Fetal Medicine
• Neonatology

Background:

• Persistent cloaca can lead to fetal peritonitis and ascites due to urinary or meconium backflow.
• Understanding the impact of prenatal fetal ascites is crucial for managing affected newborns.

Purpose of the Study:

• To analyze the impact of prenatal fetal ascites on postnatal clinical features and management in persistent cloaca cases.
• To compare perinatal parameters and outcomes of patients with and without fetal ascites.

Main Methods:

• Retrospective single-center cohort study.
• Inclusion of patients with isolated persistent cloaca treated between 1991 and 2021.
• Comparison of clinical features and management between groups with and without fetal ascites.

Main Results:

• Seven of 17 eligible patients had fetal ascites.
• Fetal ascites were associated with preterm birth, higher birth weight z-score, emergency cesarean delivery, and lower Apgar scores.
• Patients with fetal ascites required longer oxygen administration and urinary drainage, but had shorter neonatal hospital stays.

Conclusions:

• Postnatal management significantly differs for persistent cloaca patients with and without fetal ascites.
• Magnetic resonance imaging may aid in diagnosing persistent cloaca in cases of unexplained fetal ascites.