Abstract

PACHAJOA, Harry et al. Investigating a case of exstrophy of cloaca as a result of trigemelar pregnancy. Salud(i)ciencia [online]. 2018, vol.23, n.2, pp.144-148. ISSN 1667-8682.

Abstract Introduction: Exstrophy of cloaca sequence (omphalocele, exstrophy of the cloaca, imperforate anus y spinal defects; MIM 258040) is a rare congenital malformation secondary to a mesoderm defect around the 4th-5th week of gestation which will form the urorrectal septum, lumbosacral somites and infraumbilical mesenchyme. The gold-standard diagnosis is through prenatal ultrasound; however, it can be difficult to perform with accuracy in cases of multiple pregnancies. We report the case of a newborn girl, product of triplet pregnancy, born with cloacal exstrophy which was diagnosed ultrasonographically during week 21. Objective: Report the case of a newborn girl, product of triplet pregnancy, born with cloacal exstrophy which was diagnosed ultrasonographically, and provide information to physicians about etiology, phenotype and appropriate genetic counseling. Case report: A 23-year-old mother in the 33rd week of triplet pregnancy presents with uterine contrations to the hospital; furthermore, she had a previously identified triplet #2 with an abdominal wall defect and kidney anomalies. The triplets were delivered via cesarean section; triplet #2 is diagnosed with cloacal exstrophy, omphalocele and imperforate anus. A multidisplinary approach is made in conjunction with psychosocial support, nutritional support, urogenital surgery team and the intensive care unit in order to correct this defect. Conclusion: An optimal approach of this congenital malformation requires an early prenatal diagnosis that allows the preparation of a multidisciplinary team, and also allows adequate counseling to be provided to the parents. An adequate prenatal ultrasound is crucial if it is considered that multiple pregnancies are more prone to congenital malformations.

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