Dorairajan Gowri, Subbaiah Murali S, Shanbhag Esha R
Department of Obstetrics and Gynaecology, Jawaharlal Nehru Institute of Post Graduate Education and Research, Pondicherry, India.
J Obstet Gynaecol Res. 2019 May;45(5):1076-1078. doi: 10.1111/jog.13933. Epub 2019 Feb 13.
Lymphedema of filarial origin affecting the vulva is extremely rare. It is a dilemma if seen in a pregnant woman as there are no guidelines regarding excision and the mode of delivery. With the World Health Organization-driven global program to eradicate filaria, it is unfortunate to see such cases. We report of a woman who had massive lymphedema of both the labia majora following filarial infection with a small secondary ulcer. She presented to our outpatient department in early pregnancy. After detailed counseling with the couple, a decision was taken for excision. The same was carried out. The wound healed well but the lymphedema recurred after 6 weeks. She was thereafter managed symptomatically. Pregnancy advanced without any complication. Her intrapartum management for a successful vaginal delivery is outlined in the report.
丝虫性起源的外阴淋巴水肿极为罕见。若在孕妇中出现，会是个难题，因为尚无关于切除及分娩方式的指南。在世界卫生组织推动的全球根除丝虫计划下，仍见到此类病例令人遗憾。我们报告一例女性，在丝虫感染后双侧大阴唇出现巨大淋巴水肿并伴有一个小的继发性溃疡。她在孕早期前来我们门诊就诊。在与这对夫妇进行详细咨询后，决定进行切除手术。手术顺利进行，伤口愈合良好，但6周后淋巴水肿复发。此后对她进行了对症处理。妊娠进展顺利，无任何并发症。报告中概述了她为成功进行阴道分娩的产时管理情况。
