Genitourinary tract malformations and maternal cocaine abuse.

We report on 4 cases of congenital urologic anomalies in association with maternal cocaine abuse and review all 23 cases documented in the literature. Male infants predominate and have either isolated genital abnormalities, hydronephrotic conditions, or classic prune-belly syndrome. Female infants present with hydronephrosis or cloacal abnormalities along with masculinization of the external genitalia. Cocaine disrupts morphogenesis by causing intense vasoconstriction of the uterine and fetal circulation. Interruption of calcium metabolism may also be responsible for the hydronephrosis observed.