A neonate born at 36 weeks of gestation through vaginal route with a birth weight of 2.1 kg was noted to have abnormal genitalia. There was bilaterally symmetrical duplication of labia minora, urethral openings, vaginal openings and anal dimples (Fig. 1). Both the anal openings were imperforate. Single pair of labia majora was visible on either side. The child was passing meconium through both the vaginal openings suggestive of bilateral recto-vaginal fistulae. On ultrasonography, kidneys were normal with no duplication of pelvicalyceal system. Child had single urinary bladder, two urethra, single uterine cavity, single cervix with two vagina. Keeping in view the clinical and sonographic findings, we made a diagnosis of caudal duplication syndrome. The neonate later died due to shock and renal failure.

Fig. 1 Duplication of labia minora (yellow arrow), urethral openings (blue arrow), vaginal orifices (red arrow) and anal dimples (black arrow).