A full-term female newborn with a BW of 3540 g was born at 39 weeks of gestation via CS for breech presentation from a 35-year-old mother G1P1; Apgar score was 9 and 10 at 1st and 5th minute, respectively. On the ultrasound of the second trimester’s anatomy scan, mildly dilated lateral ventricles were detected, a finding that was confirmed by a cranial ultrasound on the 4th day of life. The first physical examination revealed a mildly erythematous sulcus extending from the posterior vaginal fourchette to the anterior anal orifice (). The diagnosis of perineal groove was confirmed by a Pediatric Surgeon. Since no other anorectal or genital anomalies were present and the baby passed stools normally, the perineal defect was simply observed and remained stable throughout the neonate’s 5-day hospitalization. Mild improvement in the epithelization of the area was already evident at discharge ().
A full-term female newborn with a birth weight (BW) of 3440 g was born at 39 weeks of gestation via cesarean section (CS) for breech presentation from a 37-year-old mother Gravida 3 Para 3 (G3P3); Apgar score was 6 and 10 at 1st and 5th minute of life, respectively. Baby was apneic at birth and received five inflation breaths, followed by good response with vigorous crying, good muscle tone and heart rate. The pregnancy was uneventful apart from a single echogenic intracardiac focus that was detected on the second trimester anatomy scan and was confirmed, both by fetal echocardiography (ECHO) at 22+6 weeks and a post-natal follow-up ECHO at 40 days of life, with no other abnormal findings. On the first physical examination, a midline defect was noticed on the newborn’s perineum, which formed an erythematous sulcus resembling a rupture that expanded about 1 cm from the posterior vaginal fourchette to the 12 o’clock position of the anterior anal opening. Both external genitalia and the anal orifice were intact and normally positioned. No active blood or passage of meconium via the vaginal opening was observed. The obstetrician placed four absorbable sutures in the malformed perineum, as he thought the defect represented tear of the area, and the newborn was transferred to the neonatal unit for prompt pediatric surgical evaluation. Frequent and meticulous hygiene of the affected area was maintained and a course of intravenous antibiotics was administered. The newborn remained stable throughout hospitalization with no evidence of infection. Parents refused to attend follow-up outpatient clinic (neonatal and pediatric consultation), and therefore we followed-up the case by frequent phone interviews; according to information provided by them, the infant had a full cicatrization of the perineal defect, with no defecation issues or local infection incidences.