Experience with neonatal hydrometrocolpos in the Niger Delta area of Nigeria: Upsurge or increased recognition?

Abstract

Background:Hydrometrocolpos (HMC) is a clinical condition in which there is a cystic distension of the vagina (hydrocolpos), uterus and sometimes, fallopian tubes (hydrosalpinx) with fluid. This study described our experience with cases of HMC seen in our practice, and highlighted the flare in our practice.Patients and Methods:A retrospective study of cases of HMC managed at the University of Port Harcourt Teaching Hospital between September 2010 and August 2012.Results:There were seven cases; their ages ranged from 2 to 27 days (median 13 days). All the patients had abdominal distension but abdominal mass was obvious only in four. Other features varied depending on the presence of sepsis or other associated anomalies. The diagnosis of HMC was missed in all cases by the referring clinicians. One patient was referred with the diagnosis of tracheoesophageal fistula and esophageal atresia, 2 with bladder outlet obstruction, 1 with intestinal obstruction, 2 with anorectal malformation, and 1 with neonatal sepsis. Ultrasound identified bulky uterus in two cases and upper urinary tract dilatation in 3 patients. Six patients had laparotomy, 1 had hymenotomy only. Postoperative complications were basically wound sepsis and rectovaginal fistula resulted.Conclusion:Diagnosis of HMC should be considered as a differential in newborn girls presenting with lower abdominal mass. Attention to clinical detail is necessary to avoid a misdiagnosis.

A rare cause of abdominal cyst in the neonatal period: Hydrometrocolpos

“…The HMC arising from vaginal atresia is an extremely rare neonatal condition commonly presenting with an abdominopelvic mass [3]. The mass often occurs as a result of increased mucus secretion by the uterine and cervical glands stimulated by maternal estradiol in the presence of vaginal outlet obstruction [5]. In the case presented, the Müllerian ducts did not merge with the lower section of the vagina arising from the urogenital sinus.…”

“…Hydrocolpos is defined as the accumulation of secretions in the vagina while HMC refers to the accumulation of secretions both in the vagina and uterus [5]. HMC is mostly caused by imperforate hymen and rarely caused by other conditions including labial adhesions, transverse vaginal septum, vaginal atresia, vaginal agenesis, and cloacal malformations [6].…”

Hydrometrocolpos and Post-axial Polydactyly Complicated With Acute Intestinal Obstruction and Hydroureteronephrosis

“…Newborns with HMC could be asymptomatic at birth, which can make the diagnosis difficult if findings are not obvious during prenatal ultrasounds. This disorder could be diagnosed in some patients as diverse complications arise [ 10 ] like this particular case, which happens due to continued estrogenic stimulation by the mother, more cervical and uterine secretions accumulate and could cause compression of certain adjacent structures within the infant. Cases of hydronephrosis [ 11 ], intestinal obstruction [ 4 ], rupture and infection of the HMC [ 5 ] have been reported as in this patient, which complicated the course of management.…”

Hidrometrocolpos neonatal: a propósito de un caso de difícil diagnóstico

“…El himen imperforado corresponde a 0,1% de las niñas nacidas a término (4) , pero rara vez se asocia a hidrocolpos o hidrometrocolpos, muy relacionado con los niveles de estrógenos, que suelen permanecer bajos en el período perinatal y la infancia, responsables de la producción de moco de las glándulas cervicales; esta recién aumenta en la adolescencia, momento cuando se le diagnostica (2,(4)(5)(6)(7) . Adicionalmente se ha descrito hidrometrocolpos por acumulación de orina secundaria a fístulas vésico-vaginales (4) .…”