Ultrasonographic Diagnosis of a Uterine Fusion Anomaly Associated with Neonates with Unilateral, Ectopic, Multicystic, Dysplastic Kidney

ABSTRACT

PURPOSE: The purpose of this paper is to reinforce the necessity of careful ultrasonographic evaluation of the uterus to detect uterine fusion anomaly in female neonates who were detected as having a unilateral, ectopic, multicystic, dysplastic kidney (MCDK) on fetal US. MATERIALS AND METHODS: We detected eight unilateral ectopic MCDK on fetal US of second trimester and neonatal ultrasonography between October 2003 and February 2009; neonatal US were taken at 2 to 10 days after birth for the initial evaluation of MCDK. Uterine fusion anomaly, vaginal obstruction and other associated urogenital anomalies were evaluated by neonatal US. RESULTS: Four of eight female neonates with unilateral ectopic MCDK showed a double uterus on neonatal US. They all showed hemivaginal fluid collection. Obstruction of the hemivagina and vaginal septum were depicted in two cases. A perivaginal cyst was seen in three cases, and in two cases the cyst was connected with the vaginal cavity. An ipsilateral perivaginal tubular structure was seen in one case, which was indicative of a ureteral remnant. There was no associated anomaly in the contralateral kidney except for a tiny cortical cyst in one case. CONCLUSION: The careful ultrasonographic evaluation of the uterus is important in female neonates who showed the ectopic MCDK on fetal US. In addition, it may help to detect the fusion anomaly that is otherwise difficult to detect on fetal US and to devise a treatment plan to prevent upcoming complications.