A Case of Complete Urorectal Septum Malformation Sequence: Successful Vesicoamniotic Shunting for Obstructive Uropathy

Complete urorectal septum malformation (URSM) sequence is a severe malformation affecting the urinary, genital and alimentary tracts. It is highly lethal due to severe renal dysfunction and pulmonary hypoplasia. Here we present a case of complete URSM sequence, where vesicoamniotic shunts were placed during midtrimester for obstructive uropathy. A 29-year-old woman was found to have a fetal abdominal cyst at 10 +6 weeks of gestation. Obstructive uropathy was diagnosed and a vesicoamniotic shunt was placed at 14 +3 and 20 +0 weeks of gestation. Subsequent ultrasound findings were suggestive of URSM sequence. The infant was delivered by cesarean section at 34 +6 weeks of gestation, and complete URSM sequence was diagnosed after birth. Obstetricians should be attentive to the possibility of complete URSM sequence when prominently dilated lower abdominal cyst is detected by ultrasonography. This case is indicative of the usefulness of vesicoamniotic shunting for obstructive uropathy of complete URSM sequence. J Clin Gynecol Obstet. 2014;3(3):117-120 doi : http://dx.doi.org/10.14740/jcgo283w