Prenatal diagnosis of cloacal malformation in fetus with hydrometrocolpos: imaging and invasive intrauterine procedures

Abstract Hydrometrocolpos(HMC) is a rare prenatal ultrasound abnormality, presenting in two distinct types: the urinary type and the secretory type. The urinary variation is intricately linked to cloacal malformations, thereby posing a heightened risk of perinatal adverse events. Additionally, children affected by this type often face long-term challenges that impact their quality of life. We present a case involving hydrometrocolpos accompanied by oligohydramnios. Prenatally, the condition was strongly indicative of cloacal malformation based on imaging manifestations and intrauterine procedures, a suspicion that was later confirmed through postnatal autopsy. Due to the extremely low incidence of HMC, current literature reports are case reports and there are no studies that comprehensively analyze the prognosis of the disease, this research fills this gap by statistically analysing the present case as well as 29 prenatal HMC cases reported in the previous literature. Gestational week at initial detection and combined fetal ascites are meaningful predictors of cloacal malformations in HMC fetuses. Intrauterine procedures can be used to preserve organ function in complete lower urinary tract and oligohydramnios secondary to HMC. In addition, biochemical analysis of HMC fluid can differentiate between urinary HMC and secretory HMC.