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宫颈阴道发育不全:子宫体先前重新植入新阴道后足月自然妊娠:病例报告

Cervicovaginal agenesis: spontaneous gestation at term after previous reimplantation of the uterine corpus in a neovagina: Case Report.

作者信息

Acién P, Acién M I, Quereda F, Santoyo T

机构信息

Service of Obstetrics and Gynecology, University Hospital of San Juan, Campus of San Juan, Alicante, Spain.

出版信息

Hum Reprod. 2008 Mar;23(3):548-53. doi: 10.1093/humrep/dem420. Epub 2008 Jan 12.

Abstract

We present an exceptional case of a patient with complete cervical atresia and total vaginal aplasia. After McIndoe vaginoplasty, cervicoitsmic resection with implantation and reimplantation of the uterine corpus in the neovagina, and conservative surgery for endometriosis, the patient had normal menstruations and became pregnant spontaneously. A Caesarean section was performed at week 36. This is the third published case report of a successful spontaneous pregnancy and Caesarean section at term in a patient with complete cervicovaginal aplasia, and the first published case study of a patient becoming pregnant after McIndoe vaginoplasty, cervicoistmic resection and utero-neovaginal anastomosis. Gestation developed successfully without cerclage. We recommend conservative surgery in patients with congenital cervical atresia. McIndoe vaginoplasty should be performed as soon as possible in adolescence if there is associated vaginal aplasia. Nevertheless, fibrotic stenosis can occur, even after several years and, therefore, additional operations and uterine reimplantation may be required.

摘要

我们报告了一例极为罕见的病例,患者存在完全性宫颈闭锁及完全性阴道发育不全。在进行麦金杜阴道成形术、宫颈峡部切除术并将子宫体植入及重新植入新阴道,以及针对子宫内膜异位症的保守手术后,患者月经恢复正常并自然受孕。孕36周时进行了剖宫产。这是第三例关于完全性宫颈阴道发育不全患者成功自然受孕并足月剖宫产的病例报告,也是首例关于患者在接受麦金杜阴道成形术、宫颈峡部切除术及子宫 - 新阴道吻合术后成功受孕的病例研究。孕期顺利进展,未行宫颈环扎术。我们建议对先天性宫颈闭锁患者采取保守手术。如果伴有阴道发育不全,应在青春期尽早进行麦金杜阴道成形术。然而,即使数年之后仍可能出现纤维化狭窄,因此可能需要额外的手术及子宫重新植入术。

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