Kaji Takashi, Maeda Kazuhisa, Sogawa Eishi, Yoshida Atsuko, Yonetani Naoto, Ishibashi Hiroki, Irahara Minoru, Iwasa Takeshi
Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Department of Obstetrics and Gynecology, Shikoku Medical Center for Children and Adults, Zentsuji, Japan.
J Obstet Gynaecol Res. 2021 Aug;47(8):2767-2772. doi: 10.1111/jog.14824. Epub 2021 May 10.
Imperforate anus (IA) requires urgent treatment after birth, which is dependent on the type of IA, and is also frequently associated with other congenital abnormalities. Most patients with IA have an accompanying fistula, whose location is strongly associated with the type of IA. The fistula location can be a key factor in defining appropriate treatment, especially in neonates presenting with severe associated abnormalities. Herein, we report three cases of IA in which fistulas were detected and localized prenatally. Examination of the fetal pelvis through the sagittal or coronal view, using high-frequency transducers, revealed the location of the fistulas. In particular, the sagittal view obtained using the fetal infracoccygeal or perineal approach allowed us to determine the precise anatomy of the fistulas. Neonatal assessment confirmed the fistula locations. We recommend using the sagittal view obtained using the fetal infracoccygeal or perineal approach with high-frequency transducers to assess fistulas in fetuses with IA.
肛门闭锁（IA）在出生后需要紧急治疗，这取决于IA的类型，并且还经常与其他先天性异常相关。大多数IA患者伴有瘘管，其位置与IA的类型密切相关。瘘管位置可能是确定适当治疗方法的关键因素，尤其是对于伴有严重相关异常的新生儿。在此，我们报告三例产前检测到并定位瘘管的IA病例。使用高频探头通过矢状面或冠状面检查胎儿骨盆，揭示了瘘管的位置。特别是，采用胎儿尾骨下或会阴入路获得的矢状面视图使我们能够确定瘘管的确切解剖结构。新生儿评估证实了瘘管位置。我们建议使用高频探头采用胎儿尾骨下或会阴入路获得的矢状面视图来评估患有IA的胎儿的瘘管。
