![]() ![]() ![]() The introduction of fetal MRI has been a great advance in this field, ,, , and numerous studies have now settled on clues to diagnose these cloacal malformations. A major question in this situation remains identification of a cloacal malformation because of the technical surgical challenge it represents and the implication on parental counseling. To make the distinction between an isolated hydrocolpos, a urogenital sinus, a megacystis or a cloaca can be challenging by ultrasound only. All these malformations can share almost identical prenatal presentations with fetal cystic pelvic or abdominopelvic masses diagnosed on second trimester ultrasound,. Considering pelvic obstructive malformations in female fetuses, this situation is frequently encountered as the panel includes benign situations such as imperforate hymen or more complex defects with a more uncertain prognosis and completely different therapeutic implications such as urogenital sinus, vaginal atresia, blind hemivagina, persistent cloaca or more complex urogenital defects,. ![]() Despite huge progress, difficult situations remain in which one has to discuss the prognosis of a suspected malformation, this point being the most important one for future parents. Indeed, once Pandora's box is open, one has to deal with worried parents, expecting clear explanations about their impending child. Prenatal diagnosis is a difficult exercise. ![]()
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