Introduction
Hematometrocolpos is defined as the accumulation of blood or menstrual fluid in the uterus and vagina due to obstruction. While obstruction can be caused by various pathologies in adulthood, such as malignancies or adhesions secondary to infection or surgical procedures, the most common cause in childhood and adolescence is congenital anomalies, such as imperforate hymen or a transverse vaginal septum.1 Occasionally, the accumulation of fluid in the uterine cavity begins in fetal life and can be identified prenatally. Fetal hematometrocolpos is a rare finding with a reported incidence of 1 in 16,000 female births.2
Timely diagnosis before delivery is crucial as it enables clinicians to formulate an appropriate management plan for the newborn, avoiding unnecessary investigations and enabling surgical intervention within the first few days of life. This is advantageous for early resolution of the lesion and significantly reduces the chances of complications resulting from delayed diagnosis and treatment.
Here we present a case of fetal hematometrocolpos diagnosed and followed up exclusively by prenatal and postnatal ultrasound scans allowing for effective immediate postnatal surgical treatment, evidenced by full resolution by three months of age.