The female genital tract occasionally fails to develop normally. The more common abnormalities are fortunately quite easy to treat. If the vagina fails to communicate with the vulva, a patient may present at birth with hydrocolpos (rare, described below), or at puberty with haematocolpos (uncommon), as described in Section 20.14.
FEMALE GENITAL ABNORMALITIES If you are shown a baby girl with an ABSENT VAGINA, examine her carefully and consider the possibility of labial fusion. This is common, whereas an absent vagina is rare. If her labia minora are not obviously present and normal, and you can see even the faintest line of adhesions, this is what she has. Gently separate them with a probe. Ask her mother to clean her vulva with tepid boiled water daily for a week, and to bring her to a nurse at one week and two weeks.
If you feel a LOW ABDOMINAL MASS IN A GIRL BABY (rare), examine her vulva and vagina. If you find a bulging membrane just above her vagina, her uterus and vagina are full of watery fluid[md]hydrocolpos.
If the membrane feels thin, incise it with a cross- shaped incision. Do nothing else, or you will increase the risk of infection. She will settle down.
If there is no thin membrane, her vagina is absent through all or part of its length. You have a difficult problem. Refer her.