Hydrocolpos, uterus didelphys and septate vagina in association with ascites: antenatal sonographic detection.

Hydrometrocolpos is a rare congenital disorder consisting of cystic dilation of the vagina and uterus and accumulation of mucus secretions resulting from genital tract obstruction.1 The obstruction can be produced by imperforate hymen, transverse vaginal membrane, or some degree of vaginal atresia.2 Excessive intrauterine stimulation of the cervical mucus glands by circulating maternal estrogens produces the accumulated fluid.1,3 This was first described by Godfroy in 1856.1,4,5 Only sporadic cases were reported until 1940, when Mahoney and Chamberlain presented their definitive descriptions of the condition. Since then 200 cases have been presented or reviewed in the literature.1,5 Hydrocolpos or hydrometrocolpos commonly first appears either in the neonatal period or at menarche.5 This report describes the antenatal sonographic detection of a cystic pelvic mass subsequently proved to be hydrocolpos in a fetus with ambiguous genitalia and uterovaginal duplication. Few reports on the prenatal diagnosis of hydrometrocolpos by ultrasonography have been published. Davis and coworkers were the first to describe the antenatal sonographic diagnosis of hydrometrocolpos caused by an imperforate hymen.5 Hill and Hirsch reported an additional case of fetal hydrocolpos,3 also caused by imperforate hymen, detected by sonography,1 and Russ and colleagues described a case of hydrometrocolpos occurring with uterus didelphys and septate vagina detected in utero.4 Our case is notable for the association of fetal ascites and uterovaginal duplication in a patient with persistent urogenital sinus.