ULTRASOUND OF HYDROCOLPOS / HYDROMETROCOLPOS

 

  • Female fetus.
  • The pathognomonic physical finding in persistent cloaca is a single perineal orifice between the labia minora is probably not possible to demonstrate sonographically.
  • Usually a hypoechoic or anechoic pelvic mass which may contain low level echoes (1,2).

 

 

  • Occasionally a homogeneous midline pelvic mass (3).
  • Distended vagina situated posterior to the bladder and anterior to the rectum. The uterus is rarely involved due to the ability of the vagina to distend (4).
  • Membrane bulging through the perineum and spreading the labia majora (2).
  • ± Cervical distention.
  • ± Uterine distention.
  • ± Fluid-debris level (distended vagina).
  • Bladder often not identified (compression by distended vagina).
  • Duplication of the uterus and vagina in 41%.

 

Cystic mass in pelvis extending up to perineum (22 wks GA)

Fluid level in vagina

Communication between vagina and uterus

Bladder compressed by distended vagina

Single umbilical artery

Uterus and vagina

Scan at 32 weeks of gestation

Acsites

 

 

 

 

REFERENCES
  1. Davis GH, Wapner RJ, Kurtz AB et.al. Antenatal diagnosis of hydrometrocolpos by ultrasound examination. J Ultrasound Med 1984;3:371-374.
  2. Winderl LM, Silverman RK. Prenatal diagnosis of congenital imperforate hymen. Obst Gynecol 1995;85(5):857-860.
  3. Hill SJ, Hirsch JH. Sonographic detection of fetal hydrometrocolpos. J Ultrasound Med 1986;5:211-213.
  4. Kay R, Tank ES. Principles of management of persistent cloaca in the female newborn. J Urol 1977;117:102-104.