Prenatal perineal findings and possible clinical scenario

Abstract

The fetus’s perineal area has not traditionally been the focus for the prenatal echoscopy, mainly because adequate visualization depends on fetus’s position. However, it is precisely thanks to the targeted attention to the perineal area that we sometimes manage to find not only quite curious but clinically significant findings.Sacrococcygeal teratoma can grow large and affect the natural birth process. When localized in the perineal region, it sometimes leads to defecation and micturition disorders. In addition, intestinal loops may be located in the tumor structure, which leads to deformation and the risk of hernia formation. In the presence of a giant sacrococcygeal teratoma, the following events may occur: heart failure leading to fetal hydrops, obstruction of the urinary tract, obstruction of the gastrointestinal tract, impaired innervation of organs due to compression, intratumoral hemorrhage, intrauterine anemia. Hymenal pathology is quite rare in everyday clinical practice. Usually, it is one of the two most common nosologies: hymenal polyp or imperforate hymen. These two anomalies occur almost exclusively in childhood or immediately after menarche. At a later age, the preserved or dysmorphic hymen can present difficulties in diagnosing and treating intravaginal pathological processes. In this article, we would like to bring to your attention two clinical cases with different prognosis to draw colleagues’ attention to the need for a targeted assessment of the perineal area and correct prenatal counseling for a couple, because the ranking of the severity of the probable consequences is significant. Thus, some findings will require only adequate monitoring in childhood, others – may be the cause of premature birth, changes in delivery tactics or immediate surgery after birth.