Twin girls presented to the newborn nursery after delivery. The infants were born at 37\nweeks and 6 days gestation via spontaneous vaginal delivery to a 16-year-old gravida 1\nmother. Screening laboratory studies were negative, including group B streptococcus, human\nimmunodeficiency virus, hepatitis B, rapid plasma reagin, gonorrhea, and chlamydia.\nComplications during the pregnancy included gestational hypertension (diet controlled) and\ndichorionic diamniotic twin pregnancy. The mother had no significant medical history and\ndenied taking any medications during pregnancy. She also denied tobacco, alcohol, or illicit\ndrug use.\nDelivery was complicated by a breech vaginal delivery for twin B. Apgar scores were 7 at 1\nmin and 8 at 5 min, respectively, for twin A, and 7 at 1 min and 8 at 5 min, respectively,\nfor twin B.\n Birthweight was 2890 g (22nd percentile) for twin A and 2800 g (16th percentile) for\ntwin B. Neither twin sustained any trauma during delivery.\nPhysical examination in the newborn nursery revealed hypertrophic, erythematous and wet\nappearing mucosal sulci extending from the posterior vaginal fourchette to the anterior\nridge of the anus in both twins ( and ). Anus was\nnormally placed, centered in the sphincter, and patent with an anal wink present in both\ntwins. Urethral and vaginal openings were present and in appropriate locations on both\nexams. The remainder of the newborns’ exams were unremarkable. Written informed consent for\npatients’ images to be used for medical purposes was obtained from the mother of the\ntwins.\nConsultation was made to pediatric dermatology and obstetrics/gynecology who agreed with\nthe diagnosis and recommended no further intervention. The twin infants had benign neonatal\ncourses in the newborn nursery without development of complications. Screening tests\nincluding critical congenital heart disease and hearing screenings were passed for both\ntwins.\nThe twins were discharged home with primary care follow-up and a recommendation of referral\nto pediatric gynecology if the lesions did not epithelize by 2 years of age. No additional\nfollow-up data are available regarding the twins as they are followed for primary care at a\nhealth department in a different county.
A term female neonate with a BW of 2930 g was born at 38 weeks of gestation by CS, due to fetopelvic disproportion, from a 31-year-old mother G1P1; Apgar score was 9 and 10 at the 1st and 5th minute, respectively. The pregnancy was uneventful. The first physical examination revealed an erythematous mucous membrane extending from the posterior vaginal fourchette to the anterior anal orifice (). The defect was simply observed and the neonate was discharged with a reassessment plan in case of complications.