Diagnosing neonatal female genital anomalies using saline-enhanced sonography

OBJECTIVE. The purpose of this article is to show the usefulness of sonogra phy in diagnosing genital anomalies early in female neonates who have unila teral renal malformations. Our patients were three female neonates with ren al anomalies that had been detected in utero. We performed sonography of th e inner genitalia of each girl after filling the vagina with saline solutio n. In two patients with multicystic dysplastic kidney disorder, the examina tion revealed uterus didelphys with obstruction of one of the vaginas. Sono graphic examination of the third patient showed Gartner's duct cyst with re nal agenesis. CONCLUSION. The neonatal period provides a unique opportunity to use sonogr aphy to detect uterine anomalies because maternal and placental hormone sti mulation increases the size of the uterus, Simultaneous intravaginal saline instillation during imaging further improves the radiologist's ability to diagnose genital malformations precisely. This procedure is a simple, sensi tive, and inexpensive examination method that is useful in imaging female n eonates with renal dysplasia or agenesis detected in utero or in the neonat al period. Its particular value is to further characterize a cystic mass po sterior to the bladder that is seen at transabdominal sonography.