THE PELVIS OF FETUSES IN THE EXSTROPHY COMPLEX

By using a three-dimensional computed tomography (CT) scanner, we comp ared the anatomic features of the pelvis of three fetuses of same gest ational age, one with a normal pelvis representing the reference model , one with classic bladder exstrophy, and one with cloacal exstrophy. The tomography slices were selected at the same levels for each case. Three angles expressing external opening of the pelvis were defined. C omparing normal and abnormal pelvises allowed definition of three crit eria for the correction of the malformation: (a) the sum of the differ ential angles gives the amplitude of the correction needed; (b) a supr aacetabular osteotomy appears to allow best closure of the pelvic ring ; (c) only three slices of a CT scan are needed, which cannot be harmf ul, especially for neonates. Therefore, we believe that a CT scan of t he pelvis should be performed whenever an osteotomy is planned in the surgical reconstruction of bladder and cloacal exstrophy.