Congenital uterovaginal prolapse in a term neonate: a case report

Introduction: Congenital uterovaginal prolapse in neonates is a rare condition, and it is often associated with spinal cord defects. Case presentation: A 3-day-old female term neonate born via cesarean section with a weight of 3.2 Kg was admitted to our pediatric surgery unit due to a protruding mas...

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Main Authors: Jejaw Endale, Yidnekachew Getachew, Samuel Gashu, Belachew Dejene, Mihret S. Tesfaye, Hiwot Y. Anley
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Journal of Pediatric Surgery Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213576625000648
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author Jejaw Endale
Yidnekachew Getachew
Samuel Gashu
Belachew Dejene
Mihret S. Tesfaye
Hiwot Y. Anley
author_facet Jejaw Endale
Yidnekachew Getachew
Samuel Gashu
Belachew Dejene
Mihret S. Tesfaye
Hiwot Y. Anley
author_sort Jejaw Endale
collection DOAJ
description Introduction: Congenital uterovaginal prolapse in neonates is a rare condition, and it is often associated with spinal cord defects. Case presentation: A 3-day-old female term neonate born via cesarean section with a weight of 3.2 Kg was admitted to our pediatric surgery unit due to a protruding mass in the vaginal introitus and swelling in the lower back. On physical examination, the mass measured 4 by 5 cm was and appeared to be the vagina and part of the uterus. There was no discharge or bleeding. The mass was easily reducible but recurred when the patient cried. A spinal ultrasound confirmed a 3 by 2-cm defect in the lumbosacral area, consistent with a meningomyelocele. The patient also had bilateral clubfoot. A transfontanellar ultrasound showed obstructive hydrocephalus, likely due to aqueductal stenosis, and showed a small posterior fossa with an inferiorly displaced vermis, suggesting Chiari malformation type II. Several attempts at manual reduction and packing of the mass with a plaster were made but were unsuccessful. The patient was taken to the operating room for a vaginal cerclage. Two incisions were made on the vaginal wall at the 6 o'clock and 12 o'clock positions, approximately 1 cm above the fourchette. A circumferential suture of reabsorbable material was then placed and securely tied. The postoperative course was uneventful. The patient was subsequently transferred to the neurosurgery department for further evaluation and management. At three months of follow-up there have been no signs of tissue damage, and no recurrence of the prolapse. Conclusion: Congenital uterovaginal prolapse is a rare anomaly, and most cases occur in patients with neural tube defects. Vaginal cerclage seems to be a safe and effective management option.
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spelling doaj-art-0c50682fcc814e07812e48f8153cbdc02025-08-20T03:21:51ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662025-07-0111810301910.1016/j.epsc.2025.103019Congenital uterovaginal prolapse in a term neonate: a case reportJejaw Endale0Yidnekachew Getachew1Samuel Gashu2Belachew Dejene3Mihret S. Tesfaye4Hiwot Y. Anley5Pediatric Surgery Division, Department of Surgery, Black Lion Hospital, Addis Ababa, EthiopiaPediatric Surgery Division, Department of Surgery, Black Lion Hospital, Addis Ababa, EthiopiaPediatric Surgery Division, Department of Surgery, Black Lion Hospital, Addis Ababa, EthiopiaPediatric Surgery Division, Department of Surgery, Black Lion Hospital, Addis Ababa, EthiopiaSchool of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Corresponding author.School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaIntroduction: Congenital uterovaginal prolapse in neonates is a rare condition, and it is often associated with spinal cord defects. Case presentation: A 3-day-old female term neonate born via cesarean section with a weight of 3.2 Kg was admitted to our pediatric surgery unit due to a protruding mass in the vaginal introitus and swelling in the lower back. On physical examination, the mass measured 4 by 5 cm was and appeared to be the vagina and part of the uterus. There was no discharge or bleeding. The mass was easily reducible but recurred when the patient cried. A spinal ultrasound confirmed a 3 by 2-cm defect in the lumbosacral area, consistent with a meningomyelocele. The patient also had bilateral clubfoot. A transfontanellar ultrasound showed obstructive hydrocephalus, likely due to aqueductal stenosis, and showed a small posterior fossa with an inferiorly displaced vermis, suggesting Chiari malformation type II. Several attempts at manual reduction and packing of the mass with a plaster were made but were unsuccessful. The patient was taken to the operating room for a vaginal cerclage. Two incisions were made on the vaginal wall at the 6 o'clock and 12 o'clock positions, approximately 1 cm above the fourchette. A circumferential suture of reabsorbable material was then placed and securely tied. The postoperative course was uneventful. The patient was subsequently transferred to the neurosurgery department for further evaluation and management. At three months of follow-up there have been no signs of tissue damage, and no recurrence of the prolapse. Conclusion: Congenital uterovaginal prolapse is a rare anomaly, and most cases occur in patients with neural tube defects. Vaginal cerclage seems to be a safe and effective management option.http://www.sciencedirect.com/science/article/pii/S2213576625000648Case reportUterovaginal prolapseMeningomyelocelevaginal cerclage
spellingShingle Jejaw Endale
Yidnekachew Getachew
Samuel Gashu
Belachew Dejene
Mihret S. Tesfaye
Hiwot Y. Anley
Congenital uterovaginal prolapse in a term neonate: a case report
Journal of Pediatric Surgery Case Reports
Case report
Uterovaginal prolapse
Meningomyelocele
vaginal cerclage
title Congenital uterovaginal prolapse in a term neonate: a case report
title_full Congenital uterovaginal prolapse in a term neonate: a case report
title_fullStr Congenital uterovaginal prolapse in a term neonate: a case report
title_full_unstemmed Congenital uterovaginal prolapse in a term neonate: a case report
title_short Congenital uterovaginal prolapse in a term neonate: a case report
title_sort congenital uterovaginal prolapse in a term neonate a case report
topic Case report
Uterovaginal prolapse
Meningomyelocele
vaginal cerclage
url http://www.sciencedirect.com/science/article/pii/S2213576625000648
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