NEONATAL HYDROMETROCOLPOS: CLINICAL PRESENTATION AND THERAPEUTIC APPROACH

Authors

  • Rubaid Azhar Dhillon Riphah International University, Rawalpindi-Pakistan
  • Ijaz Hussain Aga Khan University Hospital, Karachi-Pakistan
  • Mohammad Aadil Qamar Ziauddin University, Karachi-Pakistan
  • Saeed Ahmed Aga Khan University Hospital, Karachi-Pakistan
  • Muhammad Usman Aga Khan University Hospital, Karachi-Pakistan
  • Saima Fayyaz Aga Khan University Hospital, Karachi-Pakistan
  • Adnan Mirza Aga Khan University Hospital, Karachi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-03-12944

Keywords:

Hydrometrocolpos, Hydronephrosis, Abdominal distention

Abstract

Hydrometrocolpos (HMC) is a rare pediatric condition characterized by significant enlargement of the uterus and vagina due to the accumulation of fluid, generally caused by a blockage in the lower vagina. This disorder typically presents in newborns with the retention of normal genital tract secretions. The following case report highlights the clinical features, diagnostic process, and treatment of HMC in a newborn. A 3-day-old female presented to the emergency with dehydration, inability to pass stool, and feeding difficulties. Upon physical examination, dehydration and abdominal distention was observed. Initial treatments included hydration and antibiotics. Further investigations confirmed hydrocolpos, leading to an HMC diagnosis due to a congenital blockage in the reproductive tract. A pigtail catheter was used to drained 20ml fluid from the uterus and vagina. Significant clinical improvement as observed. After careful monitoring and treatment, including fluid management and nutritional support, the neonate was discharged on a full oral feed regimen, with plans for long-term nephrology follow-up. Conclusions: Early recognition of HMC is essential to prevent critical complications such as urinary obstruction, renal impairment, and potential rupture of the HMC. The clinical manifestations of HMC correlate with the degree of pressure exerted on adjacent organs, commonly causing hydronephrosis and abdominal swelling.

Author Biographies

Rubaid Azhar Dhillon, Riphah International University, Rawalpindi-Pakistan

Internal Medicine

Ijaz Hussain, Aga Khan University Hospital, Karachi-Pakistan

Fellow Neonatal Medicine

Saeed Ahmed , Aga Khan University Hospital, Karachi-Pakistan

Fellow Neonatal Medicine

Muhammad Usman, Aga Khan University Hospital, Karachi-Pakistan

Fellow Neonatal Medicine

Saima Fayyaz, Aga Khan University Hospital, Karachi-Pakistan

Fellow Neonatal Medicine

Adnan Mirza, Aga Khan University Hospital, Karachi-Pakistan

Assistant Professor Neonatal Medicine

References

Bhargava P, Dighe M. Prenatal US diagnosis of congenital imperforate hymen. Pediatr Radiol 2009;1(1014):12–10.

Tseng JJ, Ho JY, Chen WH, Chou MM. Prenatal diagnosis of isolated fetal hydrocolpos secondary to congenital imperforate hymen. J Chin Med Assoc 2008;71(6):325–8.

Chen MC, Chang YL, Chao HC. Hydrometrocolpos in infants: etiologies and clinical presentations. Children (Basel) 2022;9(2):219.

Bischoff A, Levitt MA, Breech L, Louden E, Peña A. Hydrocolpos in cloacal malformations. J Pediatr Surg 2010;45(6):1241–5.

Hayashi S, Sago H, Kashima K, Kitano Y, Kuroda T, Honna T, et al. Prenatal diagnosis of fetal hydrometrocolpos secondary to a cloacal anomaly by magnetic resonance imaging. Ultrasound Obstet Gynecol 2005;26(5):577–9.

Downloads

Published

2024-09-08

Most read articles by the same author(s)

1 2 > >>