Prenatal ultrasonographic features of persistent urogenital sinus with hydrometrocolpos and ascites

Abstract

Hydrometrocolpos is a rare congenital disorder very rarely reported on prenatal sonography. In this study we report a persistent urogenital sinus with hydrometrocolpos and ascites at 24 weeks of gestation. Detailed ultrasonographic examination revealed female fetus with pelvic mass measured as 60 x 70 x 80 mm, anterior to sacral bone and inferior to bladder, and ascites, ureterocele, hydroureter, hydronephrosis but normal amniotic fluid. Further examination showed that cervical canal and uterine cavity was in continuation with the pelvic mass and dilatation of uterine tubes implicated hydrometrocolpos. Physical examination of the neonate revealed a single anterior opening at perineum and a patent anus but no visible urethral orifice. A voiding cystourethrogram demonstrated a urethrovaginal fistula. The neonate underwent ureteroneoostomy and was discharged on day 10 for follow-up and final repair. Prenatal ultrasonographic diagnosis of hydrometrocolpos in our case prevented unnecessary interventions and allowed early neonatal treatment.