Antenatal Hydrometrocolpos with Transverse Vaginal Septum and Polydactyly

This report describes a case of antenatally detected pelvic abdominal cystic mass, bilateral hydronephrosis, and oligohydramnios. Antenatal ultrasound scans could not further characterise the mass, but noted debris within the mass. Two likely diagnoses, based on the ultrasound scan findings, were a haemorrhagic ovarian cystic mass and lower urinary tract obstruction with a distended bladder. Neonatal clinical findings and neonatal magnetic resonance imaging (MRI) confirmed a diagnosis of hydrometrocolpos secondary to a transverse vaginal septum. The neonate also had postaxial polydactyly on the right hand and foot. The neonate was vomiting after feeding and could only tolerate very small feeds at a time. She was passing urine and meconium well. A nasogastric tube was inserted, and a referral to paediatric surgeons was made. Initial drainage was done 3 days after delivery to relieve pressure effects on the gastrointestinal and urinary systems. The baby was able to feed normally after the surgery. A septectomy was done at 5 months of age, and a foley catheter was left in situ for 3 weeks before removal. No cardiac anomalies or any other abnormalities were noted in the neonate. She has been followed up to 10 months of age and has attained appropriate developmental milestones for her age. Molecular tests to establish whether there was a genetic cause to her condition could not be done.