* Department of Gynecology, Félix Guyon'Hospital ** Gynecologist, Jeanne D'Arc Clinic *** Department of Neonatologiy, Félix Guyon'hospital , Réunion'Island, France.
This is a 26-year-old primigravida with a mono-amniotic pregnancy diagnosed at 12 weeks. At 16 weeks, a malformation on the pelvis of one of the twins was observed. There was also an single umbilical artery. The other twin was normal. An amniocentesis was performed (normal karyotype 46 XY). At 24 weeks, the same anomaly was reviewed. There was a physiological pyelocalyceal dilatation in both kidneys. No abdominal wall defect was observed. The spine was also normal. A hypospadia was seen with bilateral cryptorchidism. The diagnosis of an urogenital complex anomaly was suspected by the pediatric surgeon, and in particularly a cloacal dysgenesis. At 32 weeks the pelvic cyst size had increased and became multilobulated. The kidneys seemed normal at 34 weeks.
At 36 weeks, a vaginal delivery occurred. The first baby died after 15 minutes due to pulmonary hypoplasia. The second baby was healthy. The postmortem radiography of the first baby was normal. Unfortunately the parents refused a anatomopathology. The baby presented different external anomalies as:
An anal imperforation
A hypospadias with bilateral cryptorchidim
The abdomen was prominent
This baby had certainly a cloacal dysgenesis with urogenital and digestive anomalies.
Transverse view at 24 weeks showing a pelvis cyst and normal kidney with physiological pyelocaliceal dilatation.