細田 修司¹, 岩崎 昭宏², 草西 洋¹, 水谷 不二夫¹

Shuji HOSODA¹, Akihiro IWASAKI², Hiroshi KUSANISHI¹, Fujio MIZUNOYA¹

¹明石市立市民病院産婦人科, ²明石市立市民病院臨床検査科

¹Department of Obstetrics and Gynecology, Akashi Municipal Hospital, ²Hospital Laboratories, Akashi Municipal Hospital

キーワード : Enlargement of the vagina, Atresia ani, Vaginography, Congenital atresia of the intestine

A 31-year-old woman, gravida 2, para 1, was admitted at 38 weeks' gestation for the management of preeclampsia. Ultrasonography revealed evidences of fetal intestinal atresia, especially in the rectal portion, as several echo-free spaces in the abdomen. 3 days after admission, she had a normal spontaneous delivery of a 1,870 gm female infant with Apgar scores of 9 and 10 at 1 and 5 minutes, respectively. The echo-free space in infant abdomen was not detected by ultrasonography, but vaginography revealed evidence of enlargement of the infant's vagina. A 33-year-old woman, gravida 2, para 1, was uneventful until 36 weeks' gestation, when ultrasonography revealed evidence of fetal rectal atresia. She had a normal spontaneous delivery of a 3,450 gm female infant with Apgar scores of 10 and 10 at 1 and 5 minutes at 40 weeks' gestation. The echo-free space in the infant abdomen was detected by ultrasonography, and vaginography revealed evidence of enlargement of the infant's vagina. Our two cases may be in the category of genital pseudotumor. D.R. Kirks says that a normal newborn female may have genital hypertrophy producing an interlabial or cul-de-sac mass due to maternal estrogen effect. Several echo-free spaces in the fetal abdomen in utero may have some relation to the enlargement of fetal vagina. Careful clinical evaluation as well as ultrasonography or vaginography permits correct diagnosis of this genital pseudotumor which will recede in the weeks following birth.