Perineal Groove in a Neonate: Case report
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Perineal groove is a likely underreported congenital defect that usually occurs in females, characterized by the presence of a sulcus coursing between the genitalia and the anus.

Baby girl X was a 3,827 g appropriate-for gestational-age (AGA) neonate born at gestational age of 41 weeks and 4 days. The infant was delivered via low transverse cesarean section due to failure to progress and was found to be in brow presentation. Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores were 9 at 1 min and 9 at 5 min (-1 for color for both).

On physical exam, the infant was found to have caput succedaneum and a perineal groove. The genitourinary exam showed otherwise normal female genitalia and a patent vagina and anus. The perineal groove was a 1 mm wide × 1 mm deep, erythematous, wet sulcus running from the posterior fourchette of the vagina to the anus. The groove is flanked by minoral tails, which are an extension of the labia minora and run to the anus. No fistulas, sinuses, or tracks were noted. There was no drainage, bleeding, discoloration, or signs of infection.

The appearance of the groove did not change over the first 48 h of life. The parents were counseled that the groove would likely close spontaneously by 2 years of age. They were further educated regarding proper cleaning of the area, as the gap in the epithelium predisposes the area to infection from fecal bacteria. Critical congenital heart disease screen was normal with SpO2 of 98% in the right upper extremity and 100% in the left upper extremity. The hearing screening was normal.
Discharge physical exam was normal except for the perineal groove.

The patient experienced some intermittent erythema of the perineum possibly related to a zinc oxide ointment that ultimately resolved with an unspecified diaper cream. At 4 months of age the perineal groove was noted to be completely closed. The congenital disorder screen was normal. The child has met all milestones, has been growing at a normal pace, and has been healthy aside from urticarial allergic reactions to egg and peanut butter, and an episode of viral gastroenteritis.